Individual
EMILY LAI CONWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
34 MARK WEST SPRINGS RD FL 3, SANTA ROSA, CA 95403
(707) 573-5200
(707) 573-5417
Mailing address
325 DISTEL CIR, LOS ALTOS, CA 94022-1408
(707) 573-5200
(707) 573-5417
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
836514
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A112625
STATE MEDICAL LICENSE
CA
Enumeration date
06/24/2009
Last updated
10/25/2019
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