Active NPI
Jaime Eisen, M.D.
- Internal Medicine Physician
- San Francisco, CA
National Provider Identifier
1932295565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 35057257
- Practice address
- 632 Douglass St
San Francisco, CA 94114-3141 - Phone
- (440) 823-6599
- NPI assigned
- Oct 4, 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 35057257 | OH | Primary |
Addresses
Primary practice location
632 Douglass St
San Francisco, CA 94114-3141
Mailing address
632 Douglass St
San Francisco, CA 94114-3141
Phone (440) 823-6599
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0271521 | Medicaid | OH | |
| 35057257 | Other | OH | MEDICAL LICENSE |
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35057257 | OH | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477526400000",
"number": "1932295565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "632 DOUGLASS ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941143141",
"telephone_number": "440-823-6599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "632 DOUGLASS ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941143141",
"telephone_number": "440-823-6599"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EISEN",
"first_name": "JAIME",
"name_prefix": "Mr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-04",
"last_updated": "2016-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OH",
"license": "35057257",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0271521",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "35057257",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.