Individual provider Active NPI

Timothy Earl Korber, M.D.

  • Emergency Medicine Physician
  • Laguna Beach, CA
National Provider Identifier
1104881481
Registry record updated Jun 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
G58497 Issued in CA
Practice address
825 Emerald Bay
Laguna Beach, CA 92651-1228
Phone
(949) 494-5154
NPI assigned
Apr 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G58497 CA Primary

Addresses

Primary practice location

825 Emerald Bay
Laguna Beach, CA 92651-1228

Mailing address

825 Emerald Bay
Laguna Beach, CA 92651-1228
Phone (949) 494-5154

Other identifiers 1

IdentifierTypeStateIssuer
00G584970MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031119001000 CA Practitioner - Emergency Medicine 8123932571 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Pennsylvania State University College of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fountain Valley Emergency Physicians, P.C.Group PAC ID 5597031518, 21 clinicians

Practice addresses (Care Compare)

17100 Euclid St
Fountain Valley, CA 92708-4004
Phone (714) 966-7200

Hospital & facility affiliations

  • Uci Health-Orange Hospital, Orange, CA, CCN 050348

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G58497CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Apex Emergency Medical Group, Inc. Emergency Medicine CurrentSince Mar 1, 2017 Accepting new patients
Fountain Valley Emergency Physicians, P.C. Emergency Medicine CurrentSince Dec 1, 2017 Accepting new patients
Acute Care Medical Group of Orange Inc Emergency Medicine Past Accepting new patients
Pediatric Surgical Associates Inc a Medical Corporation Past Accepting new patients

Locations

17100 Euclid St
Fountain Vly, CA 92708
Phone (714) 966-7200

1117 E Devonshire Ave
Hemet, CA 92543
Phone (951) 652-2811

2601 E Chapman Ave
Orange, CA 92869
Phone (714) 633-0011

15248 Eleventh St
Victorville, CA 92395
Phone (760) 245-8691

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212364800000",
    "number": "1104881481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 EMERALD BAY",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926511228",
            "telephone_number": "949-494-5154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 EMERALD BAY",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926511228",
            "telephone_number": "949-494-5154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORBER",
        "first_name": "TIMOTHY",
        "middle_name": "EARL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2008-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G58497",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G584970",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Beach, CA

Sources for this page

Verify at the official NPI Registry.