Kornberg, Richard Lloyd

Kornberg, Richard Lloyd is an individual health care provider with primary practice located at 110 West Pennsylvania Ave , San Diego CA 92103-4016. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Dermatopathology. Allopathic & Osteopathic Physicians / Dermatopathology is his primary health care specialty. Kornberg, Richard Lloyd can be contacted via phone (619) 298-7546.

Contact Information

Primary practice address
110 West Pennsylvania Ave San Diego CA 92103-4016
Phone: (619) 298-7546
Fax: (619) 692-1397
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X G139000 California
Allopathic & Osteopathic Physicians / Dermatopathology 207ND0900X G139000 California

Profile Details

NPI number 1558456947
LBN Legal business name Kornberg, Richard Lloyd
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2006
Last updated Oct 5th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558456947 NPPES
California MEDICAID 00G139000

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