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NPI Code Detail

MEDICARE: MR. ERIC BURKE

MEDICARE: MR. ERIC BURKE
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
1106H00000XMarriage & Family Therapist

General Provider Information

NPI Number : 1588337224
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ERIC BURKE
Provider Business Mailing Address
First Line : 5690 SORREL HILLS AVE
Second Line :
City : CHINO HILLS
State : CA
Zip : 91709-7919
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2513 COLORADO BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90041-1004
Country : US
Telephone Number : 323-627-1469
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2021
Last Update Date : 07/28/2021

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Directions to “ MR. ERIC BURKE ” Practice Location

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