Provider Demographics
NPI:1164082368
Name:CLARKE, EMILY MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:MARIE
Last Name:CLARKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:24331 EL TORO RD STE 200
Mailing Address - Street 2:
Mailing Address - City:LAGUNA WOODS
Mailing Address - State:CA
Mailing Address - Zip Code:92637-3116
Mailing Address - Country:US
Mailing Address - Phone:949-586-3200
Mailing Address - Fax:949-900-2116
Practice Address - Street 1:24331 EL TORO RD STE 200
Practice Address - Street 2:
Practice Address - City:LAGUNA WOODS
Practice Address - State:CA
Practice Address - Zip Code:92637-3116
Practice Address - Country:US
Practice Address - Phone:949-586-3200
Practice Address - Fax:949-900-2116
Is Sole Proprietor?:No
Enumeration Date:2019-06-19
Last Update Date:2025-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA181791207XS0106X
CAFC3748350207XS0106X
IN01092456A207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA100189854Medicaid
IN01092456AOtherORTHOPAEDIC SURGERY