Individual provider Active NPI

Burton L. Eisenberg, MD

  • Surgical Oncology Physician
  • Los Angeles, CA
National Provider Identifier
1043389323
Registry record updated Aug 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
License
C129126 Issued in CA
Practice address
1441 Eastlake Ave
Los Angeles, CA 90089-0112
Phone
(323) 865-3535
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Oncology Physician 2086X0206X 12057 NH
Surgery Physician 208600000X 12057 NH
Surgical Oncology Physician 2086X0206X C129126 CA Primary

Addresses

Primary practice location

1441 Eastlake Ave
Los Angeles, CA 90089-0112

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 865-3535

Other identifiers 1

IdentifierTypeStateIssuer
30203816MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140604002131 CA Practitioner - Surgical OncologyPractitioner - General Surgery 7315954104 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
12057NHMDSurgery Physician
C129126CAMDSurgical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc CurrentSince Dec 1, 2013 Accepting new patients
Usc Care Medical Group, Inc Surgery CurrentSince Dec 1, 2013 Accepting new patients
Health Services of Fox Chase Cancer Center Past Accepting new patients
Health Services of Fox Chase Cancer Center Past Accepting new patients

Locations

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

1520 San Pablo St
Fl 1
Los Angeles, CA 90033
Phone (213) 743-9000

1441 Eastlake Ave
Los Angeles, CA 90089
Phone (323) 865-3000

1520 San Pablo St
Ste 4100
Los Angeles, CA 90033
Phone (323) 442-6000

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439251200000",
    "number": "1043389323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-865-3535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 EASTLAKE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900890112",
            "telephone_number": "323-865-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENBERG",
        "first_name": "BURTON",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2015-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "NH",
            "license": "12057",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NH",
            "license": "12057",
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "CA",
            "license": "C129126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30203816",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.