Organization
RICHARD L.KORNBERG, M.D.A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. EDITH L KORNBERG (SECRETARY/TREASURER)
(858) 459-8874
Entity
Organization
Contact information
Practice address
110 W PENNSYLVANIA AVE, SAN DIEGO, CA 92103-4016
(619) 298-7546
(619) 692-1397
Mailing address
110 W PENNSYLVANIA AVE, SAN DIEGO, CA 92103-4016
(619) 298-7546
(619) 692-1397
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
G13900
CA
Other
Enumeration date
02/02/2012
Last updated
02/02/2012
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