Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | A62408 | CA |
N | 208600000X | Surgeon | A62408 | CA |
N | 2086S0129X | Vascular Surgeon | A62408 | CA |
Y | 2086X0206X | Surgical Oncologist | A62408 | CA |
NPI | 1073527057 |
---|---|
Provider Name | Frederick Christian Eilber |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Los Angeles, CA 90095-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2006 |
Last Update Date | 23/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A624080 | (05) | CA |
G88944 | (02) | CA |