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General NPI Number Information
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NPI Number | 1306017801
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Entity Type | Organization
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Legal Business Name | BRIAN J. EICHENBERG, M.D., A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 03/12/2008
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Last Update Date | 06/01/2023
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Provider Practice Location Address
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Address Line | 24687 MONROE AVE
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City | MURRIETA
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State | CA
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Zip | 92562-9591
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Country | US
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Telephone | 951-506-1040
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Fax | 951-506-1044
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Provider Business Mailing Address
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Address Line | 24687 MONROE AVE
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City | MURRIETA
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State | CA
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Zip | 92562-9591
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Country | US
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Telephone | 951-506-1040
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Fax | 951-506-1044
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRIAN JEFFREY EICHENBERG
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Credential | M.D.
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Telephone | 951-506-1040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | A55426
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License Number State | CA
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