| |
1510 W Verdugo Ave, Ste E, Burbank, CA 91506-2472 | |
(818) 954-0510 | |
(818) 954-0419 |
Full Name | |
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Type | Facility |
Speciality | Family Medicine |
Location | 1510 W Verdugo Ave, Burbank, California |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1295983450 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | DC29743 (California) | Secondary |
207Q00000X | Family Medicine | A78999 (California) | Secondary |
207Q00000X | Family Medicine | A78697 (California) | Primary |
Mailing Address | Practice Location Address |
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1510 W Verdugo Ave, Ste E, Burbank, CA 91506-2472 Ph: (818) 954-0510 | 1510 W Verdugo Ave, Ste E, Burbank, CA 91506-2472 Ph: (818) 954-0510 |