Basic Information
| Provider Information | |||||||||
| NPI: | 1962700187 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DE JESUS | ||||||||
| FirstName: | EMERSON | ||||||||
| MiddleName: | MANUEL | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 222 W 39TH AVE | ||||||||
| Address2: | SOUND PHYSICIAN HOSPITALIST OFFICE | ||||||||
| City: | SAN MATEO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 944034364 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6505732222 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 222 W 39TH AVE | ||||||||
| Address2: | SOUND PHYSICIAN HOSPITALIST OFFICE | ||||||||
| City: | SAN MATEO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 944034364 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6505732222 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/11/2011 | ||||||||
| LastUpdateDate: | 01/19/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 01/19/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | A126743 | CA | Y | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | A126743 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0200X | A126743 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine |
No ID Information.