Erik Kolberg, BCO

Primary specialty

OcularistTaxonomy code 156FX1700X

Practice address

9663 Tierra Grande St Ste 201
San Diego, CA 92126-4570

Phone

(858) 695-2021

Fax

(858) 695-2712

NPI assigned

Apr 9, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Kolberg Ocular Products, Inc.

  • Prosthetic/Orthotic Supplier
  • San Diego, CA
  • NPI 1164466488

  Ocularist

  NPD (past)

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

{
    "created_epoch": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523232000000",
    "number": "1912404609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9663 TIERRA GRANDE ST STE 201",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921264570",
            "telephone_number": "858-695-2021",
            "fax_number": "858-695-2712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9663 TIERRA GRANDE ST STE 201",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921264570",
            "telephone_number": "858-695-2021",
            "fax_number": "858-695-2712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLBERG",
        "first_name": "ERIK",
        "name_prefix": "Mr.",
        "credential": "BCO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-09",
        "last_updated": "2018-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Ocularist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164466488",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew John Kolar
• Rahul Reddy Kolavala, M.D.
• Frederic Jerome Kolb, MD
• Mark Kolb, RN
• Kolberg Ocular Products, Inc.
• Rachel Kolden
• Rasa Lila Koletar
• Aryhk Imanuel Kolidakis
• Kolimpr'I LLC
• Jennifer Corum Kolinski, NP-C

• Technician/Technologist in San Diego, CA
• Providers in San Diego, CA by specialty
• Technician/Technologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2018; 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.