Individual
CAROL ANN KOENIGSBERGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D., PH.D.
Contact information
Practice address
8950 VILLA LA JOLLA DR STE B223, LA JOLLA, CA 92037-1715
(858) 658-0655
(877) 991-6138
Mailing address
PO BOX 1770, LA MESA, CA 91944-1770
(619) 464-1165
(619) 567-1011
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
A114400
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A114400
MEDICAL BOARD OF CALIFORNIA
CA
01
—
M-16713
IDAHO STATE BOARD OF MEDICINE
ID
Enumeration date
07/03/2010
Last updated
06/21/2022
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