Harley Ian Kornblum
M.D. | Pediatric Neurodevelopmental Disabilities | Male
Harley Ian Kornblum, M.D. is a Los Angeles, California based Pediatric doctor with medical specialization in
Pediatric Neurodevelopmental Disabilities.
Current practice location of Harley Ian Kornblum is
10833 Le Conte Ave, 12-441 Mdcc, Los Angeles, California - 90095-3075. He can be contacted on phone at
310-206-3952 and fax number 310-206-0209.
Harley Ian Kornblum is a sole proprietor of his business.
NPI number (Unique professional ID) for Harley Ian Kornblum is
1386651115 which was assigned by NPPES on 02 Aug, 2006 and it was last updated on 20 Jun, 2012.
Harley Ian Kornblum license number is
G70261 for Pediatrics Neurodevelopmental Disabilities (2080P0008X) in California.
Harley Ian Kornblum treats children having developmental delays or learning disorders including those associated with visual and hearing impairment, mental retardation, cerebral palsy, spina bifida, autism and other chronic neurologic conditions. This specialist provides medical consultation and education and assumes leadership in the interdisciplinary management of children with neurodevelopmental disorders. They may also focus on the early identification and diagnosis of neurodevelopmental disabilities in infants and young children as well as on changes that occur as the child with developmental disabilities grows.
Complete Profile:
Harley Ian Kornblum basic information including his official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Neurodevelopmental Disabilities |
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| Provider Name : | Harley Ian Kornblum |
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| Credential : | M.D. |
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| Gender : | Male |
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Business Address:
Harley Ian Kornblum address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 10833 Le Conte Ave, 12-441 Mdcc
Los Angeles, CA, 90095-3075
United States |
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| Phone Number : | 310-206-3952 |
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| Fax Number : | 310-206-0209 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1386651115 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 02 Aug, 2006 |
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| Last Updated On : | 20 Jun, 2012 |
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Medicare Participation:
Harley Ian Kornblum participates in medicare and accepts medicare insurance either directly or through association with group practice or medical facility.
| Medicare PECOS ID : | 7517120629 |
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| Medicare Enrollment ID : | I20120529000210 |
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| Primary Specialty : | Pediatric Medicine |
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| Medical School : | University Of California, Irvine, California College Of Medicine |
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| Graduation Year : | 1989 |
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| Accepts Medicare? | Yes. Harley Ian Kornblum accepts medicare insurance. |
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Group Practice Association:
Harley Ian Kornblum is associated with following Group Practice Organizations. Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name with which Harley Ian Kornblum is associated with along with the number of members in that group. He may also accept medicare indirectly via these group practices.
| Organisation Name : | Group Practice ID | No. of Members | Practice Address | Group Accepts Medicare |
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| Uc Regents | 4587568829 | 73 | 200 Medical Plz
Los Angeles, CA - 900950001 | Yes |
| Uc Regents | 4587568829 | 73 | 300 Medical Plz
Los Angeles, CA - 900950001 | Yes |
| Uc Regents | 4587568829 | 73 | 10833 Leconte Ave
Los Angeles, CA - 900953075
Ph: 3108259124 | Yes |
| Uc Regents | 4587568829 | 73 | 10833 Le Conte Ave
Los Angeles, CA - 900953075 | Yes |
Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Harley Ian Kornblum are as mentioned. Primary taxonomy code for Harley Ian Kornblum, M.D. is
2080P0008X (Pediatrics Neurodevelopmental Disabilities).
| Taxonomy Code | Speciality | Primary | License No. | State |
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| 2080P0008X | Pediatrics Neurodevelopmental Disabilities | Yes | G70261 | CA |
Legacy Identifiers:
Other legacy medical identifiers of Harley Ian Kornblum such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
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| 00G702610 | MEDICAID | CA | |
| GR0053510 | MEDICAID | CA | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 10833 Le Conte Ave, 12-441 Mdcc
Los Angeles, CA, 90095-3075
United States |
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| Phone Number : | 310-206-3952 |
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| Fax Number : | 310-206-0209 |
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Business Location:
Patients can refer following map for directions to
Harley Ian Kornblum practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.