Provider Demographics
NPI:1154346724
Name:EILBER, FREDERICK RICHARD (MD)
Entity type:Individual
Prefix:
First Name:FREDERICK
Middle Name:RICHARD
Last Name:EILBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 512025
Mailing Address - Street 2:DEPT AC6
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90051
Mailing Address - Country:US
Mailing Address - Phone:310-825-7086
Mailing Address - Fax:310-825-7575
Practice Address - Street 1:10833 LE CONTE AVE
Practice Address - Street 2:ROOM 54140 CHS
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095
Practice Address - Country:US
Practice Address - Phone:310-825-7086
Practice Address - Fax:310-825-7575
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC351132086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C351130Medicaid
CA00C351130Medicaid
CAWC35113BMedicare PIN