Active NPI
Harvey Charles Eisenberg, M.D.
- Diagnostic Radiology Physician
- Tustin, CA
National Provider Identifier
1972834836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- G37816
- Practice address
- 2722 Walnut Ave
Tustin, CA 92780-7048 - Phone
- (949) 717-4500
- Fax
- (714) 689-3519
- NPI assigned
- Jan 15, 2010
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | G37816 | CA | Primary |
Addresses
Primary practice location
2722 Walnut Ave
Tustin, CA 92780-7048
Mailing address
2722 Walnut Ave
Tustin, CA 92780-7048
Phone (949) 717-4500
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 |
|---|---|---|---|
| G37816 | CA | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1263513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263513600000",
"number": "1972834836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2722 WALNUT AVE",
"city": "TUSTIN",
"state": "CA",
"postal_code": "927807048",
"telephone_number": "949-717-4500",
"fax_number": "714-689-3519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2722 WALNUT AVE",
"city": "TUSTIN",
"state": "CA",
"postal_code": "927807048",
"telephone_number": "949-717-4500",
"fax_number": "714-689-3519"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EISENBERG",
"first_name": "HARVEY",
"middle_name": "CHARLES",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-01-15",
"last_updated": "2010-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "CA",
"license": "G37816",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tustin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.