Organization Active NPI

Errol Korn Medical Corporation

  • Gastroenterology Physician
  • Chula Vista, CA
National Provider Identifier
1891971404
Registry record updated Dec 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
G154810 Issued in CA
Legal business name
ERROL KORN MEDICAL CORPORATION
Practice address
750 Medical Center CT Ste 12
Chula Vista, CA 91911-6634
Phone
(619) 425-5544
Fax
(619) 421-3838
NPI assigned
Jan 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2025

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

Authorized official

Name
Laura Mata
Title
Office Manager
Phone
(619) 425-5544

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X G154810 CA Primary

Addresses

Primary practice location

750 Medical Center CT Ste 12
Chula Vista, CA 91911-6634

Mailing address

1044 Pacific Hill St
Chula Vista, CA 91911-6831
Phone (619) 425-5544

Other identifiers 1

IdentifierTypeStateIssuer
00G154810MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120222000271 CA Part B Supplier - Clinic/Group Practice 3274791256 Receives reassigned benefits from 1 practitioner
Practice locations: Chula Vista, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1200268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764547200000",
    "number": "1891971404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1044 PACIFIC HILL ST",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919116831",
            "telephone_number": "619-425-5544",
            "fax_number": "619-421-3838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 MEDICAL CENTER CT STE 12",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919116634",
            "telephone_number": "619-425-5544",
            "fax_number": "619-421-3838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERROL KORN MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-14",
        "last_updated": "2025-12-01",
        "certification_date": "2025-12-01",
        "status": "A",
        "authorized_official_last_name": "MATA",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "619-425-5544"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "G154810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G154810",
            "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 Dec 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.