Healthcare Provider Details

I. General information

NPI: 1174438329
Provider Name (Legal Business Name): TYGR LYNNE BURNETT DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4702 LINCOLN BLVD
MARINA DEL REY CA
90292-6902
US

IV. Provider business mailing address

269 S MARIPOSA AVE APT 601
LOS ANGELES CA
90004-5976
US

V. Phone/Fax

Practice location:
  • Phone: 310-776-7878
  • Fax:
Mailing address:
  • Phone: 562-536-2681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number310794
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number310794
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: