Basic Information
| Provider Information | |||||||||
| NPI: | 1821437344 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KORN | ||||||||
| FirstName: | ABRAHAM | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1190 WAIANUENUE AVE | ||||||||
| Address2: | |||||||||
| City: | HILO | ||||||||
| State: | HI | ||||||||
| PostalCode: | 96720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8089323000 | ||||||||
| FaxNumber: | 3105331841 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 W CARSON ST # 461 | ||||||||
| Address2: | |||||||||
| City: | TORRANCE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 905022004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3102222700 | ||||||||
| FaxNumber: | 3105331841 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/18/2013 | ||||||||
| LastUpdateDate: | 08/20/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/20/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | 193300 | NC | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 208600000X | 132067 | CA | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.