Active NPI
Jerome Norman Eisman, M.D.
- Dermatology Physician
- La Mesa, CA
National Provider Identifier
1629006226
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- C33319
- Practice address
- 8851 Center Dr
Suite 310
La Mesa, CA 91942-3017 - Phone
- (619) 749-7710
- Fax
- (619) 749-7710
- NPI assigned
- Jun 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | C33319 | CA | Primary |
Addresses
Primary practice location
8851 Center Dr
Suite 310
La Mesa, CA 91942-3017
Mailing address
PO Box 2878
La Mesa, CA 91943-2878
Phone (619) 749-7710
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C33319 | CA | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1629006226",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2878",
"city": "LA MESA",
"state": "CA",
"postal_code": "919432878",
"telephone_number": "619-749-7710",
"fax_number": "619-749-7710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8851 CENTER DR",
"address_2": "SUITE 310",
"city": "LA MESA",
"state": "CA",
"postal_code": "919423017",
"telephone_number": "619-749-7710",
"fax_number": "619-749-7710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EISMAN",
"first_name": "JEROME",
"middle_name": "NORMAN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "CA",
"license": "C33319",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.