Provider Demographics
NPI:1851897607
Name:KERBY, EMILY
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:KERBY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9373 HAZARD WAY STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1226
Mailing Address - Country:US
Mailing Address - Phone:858-810-8025
Mailing Address - Fax:858-268-1911
Practice Address - Street 1:8010 FROST ST STE 100
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-4222
Practice Address - Country:US
Practice Address - Phone:858-637-4700
Practice Address - Fax:858-637-4701
Is Sole Proprietor?:No
Enumeration Date:2018-04-02
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24270208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA24270OtherCA MEDICAL LICENSE