MEDICARE: BURBANK FOOT CARE CENTER, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0131X	Foot Surgery Podiatrist	E2586	CA
2	213E00000X	Podiatrist	E2586	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000E25860	OTHER	CA	BLUE SHIELD IND ID#
2	ZZZ09632Z	OTHER	CA	BLUE SHIELD GROUP ID#
3	E2586	OTHER	CA	STATE LICENSE #
4	199451800	OTHER	CA	US DEPT OF LABOR

General Provider Information

NPI Number	:	1013926203
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BURBANK FOOT CARE CENTER, INC.

Provider Business Mailing Address
First Line	:	191 S BUENA VISTA ST STE 315
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91505-4556
Country	:	US
Telephone Number	:	818-848-5586
Fax Number	:	818-848-2067

Provider Business Practice Location Address
First Line	:	191 S BUENA VISTA ST STE 315
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91505-4556
Country	:	US
Telephone Number	:	818-848-5586
Fax Number	:	818-848-2067

Authorized Official
Title or Position	:	PRESIDENT/PODIATRIST
Name	:	DR. STUART STEINBERG
Credential	:	D.P.M.
Telephone Number	:	818-848-5586

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	08/16/2020

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Directions to “BURBANK FOOT CARE CENTER, INC. ” Practice Location

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