1245288240

Everything you always wanted to know about DR. KORNBLUTH SYD RICHARD M.D., PH.D. but were afraid to ask.

DR. KORNBLUTH SYD RICHARD M.D., PH.D.

You can also download the this 1245288240 data report as csv | excel | json | xml
Provider Prefix Provider Last Name Provider Middle Name Provider First Name Provider Credential
DR. KORNBLUTH SYD RICHARD M.D., PH.D.
Gender:
Male
Enumeration date:
2006-05-04
Last update date:
2007-07-08
Current as of:
2007-08-28
Is sole proprietor?:
No
Is organization subpart?:
Not Answered
In PECOS?:
No
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Identifiers

identifier description issuer state active
A93107 Medicare UPIN none none 1
WG51776B Medicare ID-Type Undpecified none CA 1
00G517760 Medicaid none CA 1

Taxonomies

Taxonomy State License Number Primary?
207R00000X Internal Medicine CA G51776
207RP1001X Pulmonary Disease CA G51776

Phone Numbers

Type Number
Mailing Address Telephone Number 8585528585
Practice Location Address Telephone Number 6195433995
Mailing Address Fax Number 8585527445
Practice Location Address Fax Number 6195433183

Addresses

Type Address City State Postal Country
Mailing Address DEPT. OF MEDICINE, UNIV. CALIF. SAN DIEGO 200 WEST ARBOR DRIVE MC 8201 LA JOLLA CA 92093 CA
Practice Location Address UCSD MEDICAL CENTER 9500 GILMAN DRIVE # 0679 SAN DIEGO CA 92103 CA

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UCSD MEDICAL CENTER CA SAN DIEGO
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