MEDICARE: DR. JUDITH J BURICHIN M.D.

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	207V00000X	Obstetrics & Gynecology Physician	35067634	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	160056983	OTHER	OH	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000275784	OTHER	OH	ANTHEM
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	0302476002	OTHER	OH	CIGNA
5	0701660	OTHER	OH	UHC
6	2144464	OTHER	OH	AETNA
7	0701660	OTHER	OH	JF MOLLOY
8	6763404	OTHER	OH	CHOICE CARE

General Provider Information

NPI Number	:	1336145739
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUDITH J BURICHIN M.D.

Provider Business Mailing Address
First Line	:	1081 N CHINA LAKE BLVD
Second Line	:
City	:	RIDGECREST
State	:	CA
Zip	:	93555-3130
Country	:	US
Telephone Number	:	760-499-3899
Fax Number	:	760-499-3393

Provider Business Practice Location Address
First Line	:	1011 N CHINA LAKE BLVD STE 190
Second Line	:
City	:	RIDGECREST
State	:	CA
Zip	:	93555-3130
Country	:	US
Telephone Number	:	760-499-3640
Fax Number	:	760-499-7229

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	05/14/2021

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Directions to “ DR. JUDITH J BURICHIN M.D.” Practice Location

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