Basic Information
| Provider Information | |||||||||
| NPI: | 1598792079 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CORNFIELD | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | NACHUM | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 770 WELCH ROAD | ||||||||
| Address2: | SUITE 350 | ||||||||
| City: | STANFORD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94305 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6507235227 | ||||||||
| FaxNumber: | 6504985560 | ||||||||
| Practice Location | |||||||||
| Address1: | 770 WELCH RD | ||||||||
| Address2: | SUITE 350 | ||||||||
| City: | PALO ALTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 943041511 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6507235227 | ||||||||
| FaxNumber: | 6504985560 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/28/2006 | ||||||||
| LastUpdateDate: | 12/13/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/13/2019 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 36250 | MN | N | Allopathic & Osteopathic Physicians | Pediatrics | 2080P0203X | G87593 | CA | N | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Critical Care Medicine | 2080P0214X | 36250 | MN | N | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Pulmonology | 2080P0214X | G87593 | CA | Y | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Pulmonology |
ID Information
| ID | Type | State | Issuer | Description | 103695 | 01 | MN | UCARE | OTHER | 768072 | 01 | MN | ARAZ | OTHER | 8F752CO | 01 | MN | BCBS | OTHER | HP13091 | 01 | MN | HEALTHPARTNERS | OTHER | 48-29746 | 01 | MN | MEDICA CHOICE | OTHER | 1009080 | 01 | MN | PREFERRED ONE | OTHER | 48-70027 | 01 | MN | MEDICA PRIMARY | OTHER | 0052309 | 05 | MT | MEDICAID |