Healthcare Provider Details

I. General information

NPI: 1669512208
Provider Name (Legal Business Name): COURTLANDT C WARNER M.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 N SAN FERNANDO BLVD
BURBANK CA
91502-1208
US

IV. Provider business mailing address

127 N SAN FERNANDO BLVD
BURBANK CA
91502-1208
US

V. Phone/Fax

Practice location:
  • Phone: 818-842-4069
  • Fax: 818-848-1616
Mailing address:
  • Phone: 818-842-4069
  • Fax: 818-848-1616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAU2077
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHA2679
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: