Wallace M Korbin MD a Medical Corp

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

C18692 Issued in CA

Legal business name

WALLACE M KORBIN MD A MEDICAL CORP

Practice address

15243 Vanowen St
Suite #209
Van Nuys, CA 91405

Phone

(818) 988-0170

Fax

(818) 367-0767

NPI assigned

Jun 13, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Wallace M Korbin, MD

Title

President

Phone

(818) 988-0170

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193702400000",
    "number": "1376747394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 492267",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90049",
            "telephone_number": "818-988-0170",
            "fax_number": "818-367-0767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15243 VANOWEN ST",
            "address_2": "SUITE #209",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "91405",
            "telephone_number": "818-988-0170",
            "fax_number": "818-367-0767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALLACE M KORBIN MD A MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-13",
        "last_updated": "2007-10-30",
        "status": "A",
        "authorized_official_last_name": "KORBIN",
        "authorized_official_first_name": "WALLACE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-988-0170",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "C18692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF CALIFORNIA",
            "identifier": "C18692A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co
• Chanel Walker
• Christine Walker
• Keven Mathew Walker
• Timothy Aaron Walker
• Gregory Roy Wallace, MSW
• Patrick Joseph Walsh, M.D.
• Andrew Chun-Lih Wang, M.D.
• David Xue Yan Wang, MD
• Tipphawan Wannaprapha, LPN

• Neurological Surgery Physician in Van Nuys, CA
• Providers in Van Nuys, CA by specialty
• Neurological Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.