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Individual

RICHARD LLOYD KORNBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
110 WEST PENNSYLVANIA AVE, SAN DIEGO, CA 92103-4016
(619) 298-7546
(619) 692-1397
Mailing address
1821 CASTELLANA RD, LA JOLLA, CA 92037-3841
(858) 459-8874
(858) 459-8884

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
G139000
CA
207ND0900X
Dermatopathology Physician
Primary
G139000
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G139000
CA
Enumeration date
10/03/2006
Last updated
10/05/2011
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