Rebecca A Kornbluh, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A79844 Issued in CA

Practice address

158 Gentry St
Pomona, CA 91767-2100

Phone

(909) 244-2195

Fax

(909) 425-6635

NPI assigned

May 3, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Oct 1, 2022 through Oct 1, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1710945340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 HARRISON AVE",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917114323",
            "telephone_number": "909-244-2195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 GENTRY ST",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917672100",
            "telephone_number": "909-244-2195",
            "fax_number": "909-425-6635"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "232 Harrison Ave",
            "address_purpose": "LOCATION",
            "city": "Claremont",
            "state": "CA",
            "postal_code": "917114323",
            "country_code": "US",
            "telephone_number": "909-244-2195",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KORNBLUH",
        "first_name": "REBECCA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-03",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "159342",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A79844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joanne Ihm Koo, MD
• Sarah Kooda-Black
• Madison Kooyman
• George Kopiloff II, PT, DPT
• Eugen Kormuskin
• Laura Kosha
• Hagar Kotey, LVN
• Preeti Kotha, PHARMD
• Natasha Lynn Kotz
• Cami Kouyoumjian, PA-C

• Psychiatry Physician in Pomona, CA
• Providers in Pomona, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.