NPIMap

Organization Active NPI

Brian J. Eichenberg, M.D., a Professional Corporation

Doing business as Renuance Cosmetic Surgery Center

  • Plastic Surgery Physician
  • Murrieta, CA
National Provider Identifier
1306017801
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
A55426 Issued in CA
Legal business name
BRIAN J. EICHENBERG, M.D., A PROFESSIONAL CORPORATION
Doing business as
Renuance Cosmetic Surgery Center
Practice address
24687 Monroe Ave
Murrieta, CA 92562-9591
Phone
(951) 506-1040
Fax
(951) 506-1044
NPI assigned
Mar 12, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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

Authorized official

Name
Brian Jeffrey Eichenberg, M.D.NPI 1033323118
Title
President
Phone
(951) 506-1040

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X A55426 CA Primary

Addresses

Primary practice location

24687 Monroe Ave
Murrieta, CA 92562-9591

Mailing address

24687 Monroe Ave
Murrieta, CA 92562-9591
Phone (951) 506-1040

Other practice location 1

26520 Cactus Ave
Moreno Valley, CA 92555-3927
Phone (951) 486-4000

Other identifiers 1

IdentifierTypeStateIssuer
00A554260MedicaidCA

Other names 1

  • Renuance Cosmetic Surgery Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090518000564 CA Part B Supplier - Clinic/Group Practice 1456400647 Receives reassigned benefits from 7 practitioners
Practice locations: Moreno Valley, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

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

NPI Registry JSON

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

{
    "created_epoch": "1205280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685577600000",
    "number": "1306017801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24687 MONROE AVE",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925629591",
            "telephone_number": "951-506-1040",
            "fax_number": "951-506-1044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24687 MONROE AVE",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925629591",
            "telephone_number": "951-506-1040",
            "fax_number": "951-506-1044"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26520 Cactus Ave",
            "address_purpose": "LOCATION",
            "city": "Moreno Valley",
            "state": "CA",
            "postal_code": "925553927",
            "country_code": "US",
            "telephone_number": "951-486-4000",
            "fax_number": "951-486-4035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BRIAN J. EICHENBERG, M.D., A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-12",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A",
        "authorized_official_last_name": "EICHENBERG",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "JEFFREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-506-1040",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A55426",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A554260",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Renuance Cosmetic Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Renuance Cosmetic Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Murrieta, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.