Organization
ELYSE R. EISENBERG, MD, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELYSE RAE EISENBERG M.D. (PRESIDENT)
(707) 523-3375
Entity
Organization
Contact information
Practice address
725 FARMERS LN, STE 10, SANTA ROSA, CA 95405-6710
(707) 523-3375
(866) 870-0815
Mailing address
2685 LESLIE RD, SANTA ROSA, CA 95404-9607
(707) 477-6617
(866) 415-8441
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
G64542
CA
Other
Enumeration date
08/04/2014
Last updated
08/04/2014
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