Healthcare Provider Details

I. General information

NPI: 1700289709
Provider Name (Legal Business Name): EILBERT MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2014
Last Update Date: 10/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 COLUMBIA STE A
ALISO VIEJO CA
92656-4157
US

IV. Provider business mailing address

125 COLUMBIA STE A
ALISO VIEJO CA
92656-4157
US

V. Phone/Fax

Practice location:
  • Phone: 949-388-3131
  • Fax: 949-429-0623
Mailing address:
  • Phone: 949-388-3131
  • Fax: 949-429-0623

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SH1100X
TaxonomyHolistic Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL EILBERT
Title or Position: MEDICAL DOCTOR
Credential: M.D.
Phone: 949-388-3131