Provider Demographics
NPI:1316036387
Name:EIGELBERGER, MONICA SUE (MD)
Entity type:Individual
Prefix:DR
First Name:MONICA
Middle Name:SUE
Last Name:EIGELBERGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 LA CASA VIA
Mailing Address - Street 2:BUILDING 3, SUITE 211
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-3045
Mailing Address - Country:US
Mailing Address - Phone:925-933-0984
Mailing Address - Fax:925-933-0986
Practice Address - Street 1:130 LA CASA VIA
Practice Address - Street 2:BUILDING 3, SUITE 211
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3045
Practice Address - Country:US
Practice Address - Phone:925-933-0984
Practice Address - Fax:925-933-0986
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA68921174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI14716Medicare UPIN