MEDICARE: ROBERT G. BURNS, M.D., 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	208600000X	Surgery Physician	G035693	CA

General Provider Information

NPI Number	:	1821331547
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT G. BURNS, M.D., INC.

Provider Business Mailing Address
First Line	:	360 SAN MIGUEL DR STE 608
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-7832
Country	:	US
Telephone Number	:	949-760-1144
Fax Number	:	949-760-1588

Provider Business Practice Location Address
First Line	:	360 SAN MIGUEL DR STE 608
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-7832
Country	:	US
Telephone Number	:	949-760-1144
Fax Number	:	949-760-1588

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ROBERT G. BURNS
Credential	:	M.D.
Telephone Number	:	949-760-1144

Provider Enumeration Date	:	04/01/2013
Last Update Date	:	04/01/2013

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