Healthcare Provider Details

I. General information

NPI: 1386638153
Provider Name (Legal Business Name): STEVEN BURSTEIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2005
Last Update Date: 06/26/2023
Certification Date: 06/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1245 WILSHIRE BLVD STE 580
LOS ANGELES CA
90017-5854
US

IV. Provider business mailing address

PO BOX 31309
LOS ANGELES CA
90031-0309
US

V. Phone/Fax

Practice location:
  • Phone: 213-977-7422
  • Fax: 213-250-8945
Mailing address:
  • Phone: 213-977-7422
  • Fax: 213-250-8945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberA049626
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberA49626
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: