Healthcare Provider Details

I. General information

NPI: 1821437344
Provider Name (Legal Business Name): ABRAHAM KORN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2013
Last Update Date: 04/29/2025
Certification Date: 04/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W CARSON ST # 461
TORRANCE CA
90502-2004
US

IV. Provider business mailing address

1190 WAIANUENUE AVE
HILO HI
96720
US

V. Phone/Fax

Practice location:
  • Phone: 310-222-2700
  • Fax: 310-533-1841
Mailing address:
  • Phone: 808-932-3000
  • Fax: 310-533-1841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberMD-21954
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number193300
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number132067
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: