Provider Demographics
NPI:1134184641
Name:KORANSKY, ADA ANN (MD)
Entity type:Individual
Prefix:
First Name:ADA
Middle Name:ANN
Last Name:KORANSKY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2505 SAMARITAN DR
Mailing Address - Street 2:SUITE 404
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124-4006
Mailing Address - Country:US
Mailing Address - Phone:408-358-4000
Mailing Address - Fax:408-358-4005
Practice Address - Street 1:2505 SAMARITAN DR
Practice Address - Street 2:SUITE 404
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-4006
Practice Address - Country:US
Practice Address - Phone:408-358-4000
Practice Address - Fax:408-358-4005
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-18
Last Update Date:2008-08-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG30624207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA060053371OtherRAILROAD MEDICARE
CA060053371OtherRAILROAD MEDICARE
CA00G306240Medicare PIN
CAA44490Medicare UPIN