Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | 6830076-1205 | UT |
N | 208000000X | Pediatrician | 6830076-1205 | UT |
NPI | 1831126424 |
---|---|
Provider Name | Dr. Julie Korenberg |
First Address | Los Angeles, CA 90051-0717 |
Second Address | Los Angeles, CA 90048-1865 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 14/02/2022 |