Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | A162523 | CA |
N | 207Q00000X | Family Doctor | L4013R | AL |
N | 207Q00000X | Family Doctor | MD34724 | AL |
NPI | 1003228727 |
---|---|
Provider Name | Carrie Coxwell Eisberg |
First Address | Santa Cruz, CA 95060-2786 |
Second Address | Santa Cruz, CA 95060 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2014 |
Last Update Date | 28/10/2020 |