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NPI Code Detail

MEDICARE: MR. BARRY EIBSCHUTZ M.D.

MEDICARE: MR. BARRY EIBSCHUTZ M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RR0500XRheumatology PhysicianG78005CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164464566
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BARRY EIBSCHUTZ M.D.
Provider Business Mailing Address
First Line : 1039 MURRARY ST
Second Line : SUITE 200
City : SAN LUIS OBISPO
State : CA
Zip : 93405-2058
Country : US
Telephone Number : 805-781-0702
Fax Number : 888-225-4693
Provider Business Practice Location Address
First Line : 1039 MURRARY ST
Second Line : SUITE 200
City : SAN LUIS OBISPO
State : CA
Zip : 93405-2058
Country : US
Telephone Number : 805-781-0702
Fax Number : 888-255-4693
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2006
Last Update Date : 09/23/2016

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