Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 20892 | CA |
NPI | 1003938002 |
---|---|
Provider Name | David H Korb |
First Address | San Jose, CA 95123 |
Second Address | San Jose, CA 95123 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2007 |
Last Update Date | 08/07/2007 |