Provider Demographics
NPI:1629235585
Name:ALLEN L. ISERI M.D.
Entity Type:Organization
Organization Name:ALLEN L. ISERI M.D.
Other - Org Name:ECLIPSE MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:LLOYD
Authorized Official - Last Name:ISERI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-282-5437
Mailing Address - Street 1:478 S ANAHEIM HILLS RD
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92807
Mailing Address - Country:US
Mailing Address - Phone:714-282-5437
Mailing Address - Fax:714-282-8724
Practice Address - Street 1:478 S ANAHEIM HILLS RD
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807
Practice Address - Country:US
Practice Address - Phone:714-282-5437
Practice Address - Fax:714-282-8724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-19
Last Update Date:2014-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty