Richard Lloyd Kornberg, MD

Primary specialty

Dermatopathology PhysicianTaxonomy code 207ND0900X

License

G139000 Issued in CA

Practice address

110 West Pennsylvania Ave
San Diego, CA 92103-4016

Phone

(619) 298-7546

Fax

(619) 692-1397

NPI assigned

Oct 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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

• Richard L.Kornberg, M.D.a Professional Corporation

  • Exclusive Provider Organization
  • San Diego, CA
  • NPI 1932471125
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317772800000",
    "number": "1558456947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1821 CASTELLANA RD",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920373841",
            "telephone_number": "858-459-8874",
            "fax_number": "858-459-8884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 WEST PENNSYLVANIA AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034016",
            "telephone_number": "619-298-7546",
            "fax_number": "619-692-1397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORNBERG",
        "first_name": "RICHARD",
        "middle_name": "LLOYD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2011-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G139000",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "CA",
            "license": "G139000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G139000",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tyler Kormos, IDC
• Jeffrey David Korn, DPM
• Michael David Korn, RBT
• Tommy S. Korn, M.D.
• Michael Kornberg, M.D.
• Murray J Kornblit, M.D.
• Julie B Kornbluth
• Richard Syd Kornbluth, M.D., PH.D.
• Korne Chiropractic Corporation
• Colton Daniel Korne, DC

• Dermatopathology Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Dermatopathology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.

Verify at the official NPI Registry.