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DR. MICHAEL KORNBERG M.D.
NPI 1174786834
Psychiatry & Neurology - Child & Adolescent Psychiatry in San Diego, CA

Active since July 03, 2008Opted out of Medicare · through Feb 10, 2028
12625 HIGH BLUFF DR, SUITE 305, SAN DIEGO, CA 92130(858) 279-1223(858) 509-4789 Get Directions Write a Review

NPPES record last updated: June 16, 2010. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Michael Kornberg M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MICHAEL KORNBERG M.D. (NPI 1174786834) is an individual child & adolescent psychiatry provider in San Diego, California, licensed in California (A101909) and active in the NPI registry since July 2008. He has opted out of Medicare through February 10, 2028.

NPPES Registry Identity

NPI1174786834
Entity TypeIndividualMale
Primary Taxonomy2084P0804X
Provider Legal NameDR. MICHAEL KORNBERGCredential: M.D.
Location Address12625 HIGH BLUFF DR, SUITE 305San Diego, CA 92130-2052
Mailing Address12625 High Bluff Dr, Suite 305San Diego, CA 92130-2052 · (858) 279-1223 · Fax (858) 509-4789
Phone(858) 279-1223
Fax(858) 509-4789
Sole ProprietorYes
Enumeration DateJuly 3, 2008
Last NPPES UpdateJune 16, 2010
✔ NPI 1174786834 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0804X
License✔ Licensed in CA · A101909
Definition
Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
12625 HIGH BLUFF DR, San Diego, CA 92130
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Other Identifiers 1

Other95-1691313CA · Rady Children's Hospital San Diego, Outpatient Psychiatry

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Michael Kornberg M.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from February 10, 2022 through February 10, 2028.

Opt-Out Effective DateFebruary 10, 2022
Opt-Out In Effect ThroughFebruary 10, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. CARRIE JAFFE PH.D
Psychologist (Clinical)
12625 HIGH BLUFF DR, #101
SAN DIEGO, CA 92130
San Diego County (858) 208-9689
DR. JACQUELINE MICHELLE GAMBOA PSY.D.
Psychologist (Clinical)
12625 HIGH BLUFF DR, SUITE 114
SAN DIEGO, CA 92130
San Diego County (858) 492-8445
WCS INC.
Speech-Language Pathologist
12625 HIGH BLUFF DR, STE 104
SAN DIEGO, CA 92130
San Diego County (858) 794-9514
DR. SUSAN LAGASSE PH.D.
Psychologist (Clinical)
12625 HIGH BLUFF DR
SAN DIEGO, CA 92130
San Diego County (858) 793-8768
DR. CRISTINA BAROLET GARCIA MD
Psychiatry & Neurology (Child & Adolescent Psychiatry)
12625 HIGH BLUFF DR
SAN DIEGO, CA 92130
San Diego County (818) 634-6491
DR. DARLENE B SWEETLAND PH.D.
Psychologist (Clinical)
12625 HIGH BLUFF DR, SUITE #104
SAN DIEGO, CA 92130
San Diego County (858) 382-1137
MS. JEANNINE JOYCE REEVES MFT
Marriage & Family Therapist
12625 HIGH BLUFF DR, STE. 113
SAN DIEGO, CA 92130
San Diego County (858) 229-9346
MISS KIMBERLY DUCKER
Specialist/Technologist (Speech-Language Assistant)
12625 HIGH BLUFF DR, SUITE #113
SAN DIEGO, CA 92130
San Diego County (858) 488-4810

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Michael Kornberg's NPI number?

The NPI number for Michael Kornberg is 1174786834. It was assigned to this individual provider in the NPPES registry on July 3, 2008.

Where is Michael Kornberg located?

Michael Kornberg practices at 12625 High Bluff Dr Suite 305, San Diego, CA 92130. The listed phone number is (858) 279-1223.

What is Michael Kornberg's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Is Michael Kornberg enrolled in Medicare?

No. Michael Kornberg has opted out of Medicare through February 10, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Michael Kornberg was last updated on June 16, 2010. NPI Profile syncs with the weekly NPPES data releases published by CMS.