Basic Information
| Provider Information | |||||||||
| NPI: | 1265566814 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALTMAN | ||||||||
| FirstName: | EMILY | ||||||||
| MiddleName: | SALLY | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2286 E CARSON ST | ||||||||
| Address2: | #307 | ||||||||
| City: | LONG BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 908073044 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3108361223 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3200 MOTOR AVE | ||||||||
| Address2: | VISTA DEL MAR | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900343710 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3108361223 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/15/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | G55817 | CA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.