Healthcare Provider Details

I. General information

NPI: 1356617948
Provider Name (Legal Business Name): BURBANK PODIATRY ASSOCIATES GROUP, A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2012
Last Update Date: 10/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

241 W OLIVE AVE
BURBANK CA
91502-1825
US

IV. Provider business mailing address

2980 N BEVERLY GLEN CIR SUITE 100
LOS ANGELES CA
90077-1726
US

V. Phone/Fax

Practice location:
  • Phone: 818-848-5583
  • Fax:
Mailing address:
  • Phone: 310-474-9809
  • Fax: 888-431-8819

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: DR. FRANKLIN KASE
Title or Position: MEDICAL DIRECTOR
Credential: DPM
Phone: 818-848-5583