Individual
MR. ROBERT B EISENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1541 FLORIDA AVE, #100, MODESTO, CA 95350-4429
(209) 577-3388
(209) 338-0024
Mailing address
8851 CENTER DR, #501, LA MESA, CA 91942-3017
(619) 697-2456
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
A31900
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982938247
—
CA
01
—
CK115X
MEDICARE PTAN FOR GHP
CA
01
—
WA43540C
MEDICARE PTAN FOR GHP
CA
Enumeration date
07/14/2006
Last updated
03/13/2015
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