Healthcare Provider Details

I. General information

NPI: 1073848164
Provider Name (Legal Business Name): AARON EDWARD KORNBLITH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2009
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 PARNASSUS AVE ROOM M24, BOX 0203
SAN FRANCISCO CA
94143-0203
US

IV. Provider business mailing address

505 PARNASSUS AVE ROOM M24, BOX 0203
SAN FRANCISCO CA
94143-0203
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-1529
  • Fax:
Mailing address:
  • Phone: 415-353-1529
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License NumberG142756
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA113692
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: