Richard L Kornberg, MDA Professional Corporation
Richard L Kornberg, MDA Professional Corporation is an Exclusive Provider Organization in San Diego, California. Licensed in California. Registered with an NPI since 2012.
- Licensed in
- CA
- In the registry since
- 2012
Practice location Address checks out
110 W Pennsylvania AveSan Diego, CA 92103-4016
Phone: (619) 298-7546
Fax: (619) 692-1397
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Specialties & licences
| Exclusive Provider Organization (primary) | Taxonomy 302F00000X · Licence G13900 (CA) |
|---|
Record details
| NPI number | 1932471125 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Edith Kornberg — Secretary/Treasurer · (858) 459-8874 |
| NPI enumerated | February 2, 2012 |
| Last updated in NPPES | February 2, 2012 |
| Mailing address | 110 W Pennsylvania Ave, San Diego, CA 92103-4016 |
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