Provider Demographics
NPI:1801979083
Name:KARYN S. EILBER, M.D. INC.
Entity type:Organization
Organization Name:KARYN S. EILBER, M.D. INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KARYN
Authorized Official - Middle Name:S
Authorized Official - Last Name:EILBER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-453-2061
Mailing Address - Street 1:2020 SANTA MONICA BLVD
Mailing Address - Street 2:SUITE 570
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-2023
Mailing Address - Country:US
Mailing Address - Phone:310-453-2061
Mailing Address - Fax:310-453-2161
Practice Address - Street 1:2020 SANTA MONICA BLVD
Practice Address - Street 2:SUITE 570
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2023
Practice Address - Country:US
Practice Address - Phone:310-453-2061
Practice Address - Fax:310-453-2161
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KARYN S. EILBER, M.D. INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-23
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA62451208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW18515Medicare ID - Type UnspecifiedPROVIDER NUMBER