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General NPI Number Information
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NPI Number | 1932358983
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Entity Type | Organization
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Legal Business Name | JAMES EISENBERG MD INC
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Dates
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Enumeration Date | 09/15/2008
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Last Update Date | 09/15/2008
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Provider Practice Location Address
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Address Line | 2636 N BLACKSTONE AVE
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City | FRESNO
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State | CA
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Zip | 93703-1704
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Country | US
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Telephone | 559-225-6002
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Fax | 559-225-7116
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Provider Business Mailing Address
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Address Line | 2636 N BLACKSTONE AVE
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City | FRESNO
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State | CA
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Zip | 93703-1704
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Country | US
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Telephone | 559-225-6002
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Fax | 559-225-7116
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. JAMES W EISENBERG
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Credential | MD
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Telephone | 559-225-6003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | G23834
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License Number State | CA
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