Healthcare Provider Details

I. General information

NPI: 1801806617
Provider Name (Legal Business Name): KALI BURKE ZIVITZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 EL CAMINO REAL SUITE 205
BURLINGAME CA
94010-3224
US

IV. Provider business mailing address

1720 EL CAMINO REAL SUITE 205
BURLINGAME CA
94010-3224
US

V. Phone/Fax

Practice location:
  • Phone: 650-259-5050
  • Fax: 650-697-1317
Mailing address:
  • Phone: 650-259-5050
  • Fax: 650-697-1317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA77819
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: