Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 12057 | NH |
N | 208600000X | Surgeon | 12057 | NH |
N | 2086X0206X | Surgical Oncologist | 12057 | NH |
Y | 2086X0206X | Surgical Oncologist | C129126 | CA |
NPI | 1043389323 |
---|---|
Provider Name | Dr. Burton L. Eisenberg |
First Address | Los Angeles, CA 90031-0309 |
Second Address | Los Angeles, CA 90089-0112 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 11/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
30203816 | (05) | NH |
C15458 | (02) |