Healthcare Provider Details
I. General information
NPI: 1013926203
Provider Name (Legal Business Name): BURBANK FOOT CARE CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/05/2006
Last Update Date: 08/16/2020
Certification Date: 08/16/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
191 S BUENA VISTA ST STE 315
BURBANK CA
91505-4556
US
IV. Provider business mailing address
191 S BUENA VISTA ST STE 315
BURBANK CA
91505-4556
US
V. Phone/Fax
- Phone: 818-848-5586
- Fax: 818-848-2067
- Phone: 818-848-5586
- Fax: 818-848-2067
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 213ES0131X |
| Taxonomy | Foot Surgery Podiatrist |
| License Number | E2586 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213E00000X |
| Taxonomy | Podiatrist |
| License Number | E2586 |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
STUART
STEINBERG
Title or Position: PRESIDENT/PODIATRIST
Credential: D.P.M.
Phone: 818-848-5586