Healthcare Provider Details

I. General information

NPI: 1164423547
Provider Name (Legal Business Name): ELI GINSBURG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date: 03/22/2006
Reactivation Date: 03/29/2006

III. Provider practice location address

9001 WILSHIRE BLVD 302
BEVERLY HILLS CA
90211-1838
US

IV. Provider business mailing address

9001 WILSHIRE BLVD 302
BEVERLY HILLS CA
90211-1838
US

V. Phone/Fax

Practice location:
  • Phone: 310-276-9588
  • Fax: 310-276-5281
Mailing address:
  • Phone: 310-276-9588
  • Fax: 310-276-5281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberA18003
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: