Provider Demographics
NPI:1164423547
Name:GINSBURG, ELI (MD)
Entity Type:Individual
Prefix:DR
First Name:ELI
Middle Name:
Last Name:GINSBURG
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 1:9001 WILSHIRE BLVD
Mailing Address - Street 2:302
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-1838
Mailing Address - Country:US
Mailing Address - Phone:310-276-9588
Mailing Address - Fax:310-276-5281
Practice Address - Street 1:9001 WILSHIRE BLVD
Practice Address - Street 2:302
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-1838
Practice Address - Country:US
Practice Address - Phone:310-276-9588
Practice Address - Fax:310-276-5281
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2007-07-08
Deactivation Date:2006-03-22
Deactivation Code:
Reactivation Date:2006-03-29
Provider Licenses
StateLicense IDTaxonomies
CAA18003173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA18003Medicare ID - Type Unspecified
CAA21134Medicare UPIN