Healthcare Provider Details

I. General information

NPI: 1053099846
Provider Name (Legal Business Name): KRISTINA BURGER DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2023
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2216 NEWPORT BLVD
COSTA MESA CA
92627-1711
US

IV. Provider business mailing address

6132 ACACIA HILL DR
YORBA LINDA CA
92886-5807
US

V. Phone/Fax

Practice location:
  • Phone: 949-631-9009
  • Fax:
Mailing address:
  • Phone: 714-873-5739
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A23951
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: