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:
Health care specialties
| Specialty | Code | License # | 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 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558456947 | NPPES |
| California | MEDICAID | 00G139000 |
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