Healthcare Provider Details

I. General information

NPI: 1669402228
Provider Name (Legal Business Name): JEFFREY I KORCHEK M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3413 W PACIFIC AVE STE 110
BURBANK CA
91505-1598
US

IV. Provider business mailing address

3413 W PACIFIC AVE STE 110
BURBANK CA
91505-1598
US

V. Phone/Fax

Practice location:
  • Phone: 818-841-8488
  • Fax: 818-841-2123
Mailing address:
  • Phone: 818-841-8488
  • Fax: 818-841-2123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberG50547
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: