Individual
EVANN E EISENBERG
Active
Individual
EVANN E EISENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
A125493
CA
390200000X
Student in an Organized Health Care Education/Training Program
114010
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
114010
SID # 114010
CA
01
—
A125493
MEDICAL BOARD LISC
CA
Enumeration date
01/23/2012
Last updated
05/01/2020
Update your record
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