Individual
HARRY EISENBACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9312 SMOKETREE LN, VILLA PARK, CA 92861-1011
(805) 236-6587
Mailing address
9312 SMOKETREE LN, VILLA PARK, CA 92861-1011
(805) 236-6587
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
A30600
CA
Other
Enumeration date
04/20/2020
Last updated
04/20/2020
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