Organization
ELYSE R. EISENBERG MD, INC.
Active
Organization
ELYSE R. EISENBERG MD, INC.
Active
Other names
Elyse Eisenberg, MD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELYSE RAE EISENBERG M.D. (CEO AND PRESIDENT)
(707) 575-5355
Entity
Organization
Contact information
Practice address
725 FARMERS LN STE 10, SANTA ROSA, CA 95405-6743
(707) 575-5355
(866) 870-0815
Mailing address
725 FARMERS LN STE 10, SANTA ROSA, CA 95405-6743
(707) 575-5355
(866) 870-0815
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
G64542
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14979554911
GROUP'S NPI
—
Enumeration date
07/13/2007
Last updated
04/10/2017
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