Provider Demographics
NPI:1770748758
Name:COOK, EMILY ELLEN (DO)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:ELLEN
Last Name:COOK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:596 N OAKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-1112
Mailing Address - Country:US
Mailing Address - Phone:909-659-5470
Mailing Address - Fax:
Practice Address - Street 1:630 S RAYMOND AVE UNIT 230
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3283
Practice Address - Country:US
Practice Address - Phone:626-577-1115
Practice Address - Fax:626-577-1385
Is Sole Proprietor?:No
Enumeration Date:2008-07-18
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A10709207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology