Organization
EILEEN T. CONSORTI, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EILEEN T. CONSORTI M.D. (PRESIDENT)
(510) 848-1800
Entity
Organization
Contact information
Practice address
3000 COLBY ST, #201, BERKELEY, CA 94705-2083
(510) 848-1800
Mailing address
PO BOX 3669, SANTA ROSA, CA 95402-3669
(707) 535-4330
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G865870
CA
Other
Enumeration date
05/03/2007
Last updated
02/17/2009
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