Active NPI
Leonard M Kornreich, MD
- Pediatrics Physician
- Chula Vista, CA
National Provider Identifier
1235100447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- G21973
- Practice address
- 685 3Rd Avenue
Chula Vista, CA 91910 - Phone
- (619) 425-2151
- Fax
- (619) 425-1206
- NPI assigned
- Jan 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | G21973 | CA | Primary |
Addresses
Primary practice location
685 3Rd Avenue
Chula Vista, CA 91910
Mailing address
3860 Calle Fortunada
Suite 200
San Diego, CA 92123
Phone (858) 636-4300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G21973 | Other | CA | MD LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G21973 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children'S Primary Care Medical Group, Inc. | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pediatrics Physician
- San Diego, CA
- NPI 1184788291
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296172800000",
"number": "1235100447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3860 CALLE FORTUNADA",
"address_2": "SUITE 200",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92123",
"telephone_number": "858-636-4300",
"fax_number": "858-636-4319"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "685 3RD AVENUE",
"city": "CHULA VISTA",
"state": "CA",
"postal_code": "91910",
"telephone_number": "619-425-2151",
"fax_number": "619-425-1206"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KORNREICH",
"first_name": "LEONARD",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-27",
"last_updated": "2011-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "G21973",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MD LICENSE",
"identifier": "G21973",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chula Vista, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.