# ELIASIEH MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lunata
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306698816
- **Authorized official:** KASRA ELIASIEH MD (OWNER)
- **Authorized official phone:** (510) 899-7466

## Contact information

- **Practice address:** 3017 TELEGRAPH AVE STE 210, BERKELEY, CA 94705-2049
- **Practice address phone:** (510) 899-7466
- **Practice address fax:** (510) 899-6024
- **Mailing address:** 3017 TELEGRAPH AVE STE 210, BERKELEY, CA 94705-2049
- **Mailing address phone:** (510) 899-7466
- **Mailing address fax:** (510) 899-6024

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |
| 207WX0200X | Ophthalmic Plastic and Reconstructive Surgery Physician | — | NULL | — |
| 207WX0200X | Ophthalmic Plastic and Reconstructive Surgery Physician | — | — | — |

## Other

- **Enumeration date:** 04/05/2024
- **Last updated:** 11/13/2024