Individual provider Active NPI

Olga Valerievna Korelova, MD

  • Psychiatry Physician
  • San Diego, CA
National Provider Identifier
1225563083
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A164005 Issued in CA
Practice address
9320 Carmel Mountain Rd Ste D
San Diego, CA 92129-2159
Phone
(858) 386-0549
Fax
(877) 371-4726
NPI assigned
Apr 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A164005 CA Primary

Addresses

Primary practice location

9320 Carmel Mountain Rd Ste D
San Diego, CA 92129-2159

Mailing address

PO Box 1417
Rancho Santa Fe, CA 92067-1417
Phone (858) 386-0549

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
I20220913003960 CA Practitioner - Psychiatry 3476938309 Practice locations: San Diego, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A164005CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mark David Levine M.D. Professional Corporation Psychiatry PastSince Jul 1, 2021 Accepting new patients
Mark David Levine, MD Burlingame PC Psychiatry PastSince Jul 1, 2021 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1493337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1225563083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1417",
            "city": "RANCHO SANTA FE",
            "state": "CA",
            "postal_code": "920671417",
            "telephone_number": "858-386-0549",
            "fax_number": "858-327-3499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9320 CARMEL MOUNTAIN RD STE D",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921292159",
            "telephone_number": "858-386-0549",
            "fax_number": "877-371-4726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORELOVA",
        "first_name": "OLGA",
        "middle_name": "VALERIEVNA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-28",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A164005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.