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HARRY EISENBACH
Adult Medicine >> Family Medicine >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1619597671
Individual Registrant: HARRY EISENBACH
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
9312 SMOKETREE LN VILLA PARK, CA 92861-1011 US
Tel: 805-236-6587 Fax: --
Tel: 805-236-6587 Fax: --
Contact information for business:
9312 SMOKETREE LN VILLA PARK, CA 92861-1011 US
Tel: 805-236-6587 Fax: --
Tel: 805-236-6587 Fax: --
Registration Information:
NPI: 1619597671
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 207QA0505X | Allopathic & Osteopathic Physicians Family Medicine Adult Medicine | CA | A30600 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
