| Jason R. Kornberg, M.d., A Professional Corporation | |
|
2247 San Diego Ave Ste 134 San Diego CA 92110-2943 | |
| (858) 677-9222 | |
| Not Available |
| Full Name | Jason R. Kornberg, M.d., A Professional Corporation |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2247 San Diego Ave Ste 134, San Diego, California |
| Authorized Official Name and Position | Jason Kornberg (C.E.O.) |
| Authorized Official Contact | 8586779222 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jason R. Kornberg, M.d., A Professional Corporation Po Box 12008 La Jolla CA 92039-2008 Ph: (858) 677-9222 | Jason R. Kornberg, M.d., A Professional Corporation 2247 San Diego Ave Ste 134 San Diego CA 92110-2943 Ph: (858) 677-9222 |
| NPI Number | 1841440419 |
|---|---|
| Provider Enumeration Date | 09/19/2008 |
| Last Update Date | 05/17/2023 |
| Certification Date | 05/17/2023 |
| Medicare PECOS PAC ID | 5193094472 |
|---|---|
| Medicare Enrollment ID | O20170629001286 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841440419 | NPI | - | NPPES |
| Provider Name | Jason Kornberg |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073685764 PECOS PAC ID: 8820304827 Enrollment ID: I20150908000990 |
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