Healthcare Provider Details

I. General information

NPI: 1578476719
Provider Name (Legal Business Name): EICHENBERG AND WILENSKY APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16486 BERNARDO CENTER DR STE C150
SAN DIEGO CA
92128-2518
US

IV. Provider business mailing address

16486 BERNARDO CENTER DR STE C150
SAN DIEGO CA
92128-2518
US

V. Phone/Fax

Practice location:
  • Phone: 951-506-1040
  • Fax: 951-506-1044
Mailing address:
  • Phone: 951-506-1040
  • Fax: 951-506-1044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: BRIAN EICHENBERG
Title or Position: PRESIDENT
Credential: MD
Phone: 951-506-1040