Provider Demographics
NPI:1851492136
Name:KORMAN DOLOMIS, IRINA (MD)
Entity Type:Individual
Prefix:
First Name:IRINA
Middle Name:
Last Name:KORMAN DOLOMIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 DRESDEN DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:CA
Mailing Address - Zip Code:95648-8803
Mailing Address - Country:US
Mailing Address - Phone:916-543-5473
Mailing Address - Fax:
Practice Address - Street 1:1900 DRESDEN DR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:CA
Practice Address - Zip Code:95648-8803
Practice Address - Country:US
Practice Address - Phone:916-543-5473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA56408207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA074996OtherHEALTH NET
CAA56408OtherBLUE CROSS
CA1174078OtherFIRST HEALTH
CA37381OtherINTERPLAN
CA7181053OtherAETNA
CAMCMG128100OtherWESTERN HEALTH ADVANTAGE
CA00A564080OtherBLUE SHIELD
CA00A564080Medicaid
CA1896198OtherUNITED HEALTHCARE
CA1092262OtherGREAT WEST
CA90106692OtherPACIFICARE
CA000810354292OtherPHCS
CA6813600OtherCIGNA
CA1896198OtherUNITED HEALTHCARE
CA00A564080Medicaid