Elyse R. Eisenberg, MD, Inc.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

G64542 Issued in CA

Legal business name

ELYSE R. EISENBERG, MD, INC.

Practice address

725 Farmers LN
Ste 10
Santa Rosa, CA 95405-6710

Phone

(707) 523-3375

Fax

(866) 870-0815

NPI assigned

Aug 4, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Elyse Rae Eisenberg, M.D.NPI 1316966815

Title

President

Phone

(707) 523-3375

Specialties & licenses 1

Addresses

Tax ID family

Elyse Eisenberg MD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Elyse R. Eisenberg MD, Inc.

  • Addiction Medicine (Family Medicine) Physician
  • Santa Rosa, CA
  • NPI 1497954911
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Elyse Rae Eisenberg, M.D.

  • Addiction Medicine (Family Medicine) Physician
  • Santa Rosa, CA
  • NPI 1316966815
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1407110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407110400000",
    "number": "1003225061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2685 LESLIE RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954049607",
            "telephone_number": "707-477-6617",
            "fax_number": "866-415-8441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 FARMERS LN",
            "address_2": "STE 10",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954056710",
            "telephone_number": "707-523-3375",
            "fax_number": "866-870-0815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELYSE R. EISENBERG, MD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-04",
        "last_updated": "2014-08-04",
        "status": "A",
        "authorized_official_last_name": "EISENBERG",
        "authorized_official_first_name": "ELYSE",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "707-523-3375",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "G64542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Elo
• Kirk Elrod
• Garrett Joesph Elsberry
• Kelly Ann Elward, D.D.S.
• Elyse R. Eisenberg MD, Inc.
• Lela M Emad, M.D.
• Hila Emanuel-Cohen, LMFT
• Emericare Inc
• Joshua James Emerick
• Emine C. Loxley DMD, PC

• Clinic/Center in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.