Healthcare Provider Details

I. General information

NPI: 1467578708
Provider Name (Legal Business Name): DESIREE ROCHELLE EAKIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 PACIFIC COAST HWY STE B
SEAL BEACH CA
90740-6246
US

IV. Provider business mailing address

1500 PACIFIC COAST HWY STE B
SEAL BEACH CA
90740-6246
US

V. Phone/Fax

Practice location:
  • Phone: 562-431-7779
  • Fax:
Mailing address:
  • Phone: 562-431-7779
  • Fax: 844-779-0373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License NumberA115574
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License Number13193
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License Number13193
License Number StateNV
# 4
Primary TaxonomyN
Taxonomy Code2080B0002X
TaxonomyPediatric Obesity Medicine Physician
License Number13193
License Number StateNV
# 5
Primary TaxonomyN
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License NumberA115574
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code2080B0002X
TaxonomyPediatric Obesity Medicine Physician
License NumberA115574
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA115574
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: