Provider Demographics
NPI:1053688531
Name:KORPMAN, DENNIS WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:WILLIAM
Last Name:KORPMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3123 QUIET HILLS DR
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92029-7305
Mailing Address - Country:US
Mailing Address - Phone:650-634-4931
Mailing Address - Fax:
Practice Address - Street 1:800 S AIRPORT BLVD
Practice Address - Street 2:BLD 49 MOC UNITED AIRLINES MEDICAL DEPARTMENT
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94128
Practice Address - Country:US
Practice Address - Phone:650-634-4931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG49335207Q00000X
FLME403482083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine