Healthcare Provider Details

I. General information

NPI: 1356392716
Provider Name (Legal Business Name): DR. ALBERT E. BURNS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 09/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

669 CRESPI DR
PACIFICA CA
94044-3486
US

IV. Provider business mailing address

669 CRESPI DR
PACIFICA CA
94044-3486
US

V. Phone/Fax

Practice location:
  • Phone: 650-359-7770
  • Fax: 650-359-3449
Mailing address:
  • Phone: 650-359-7770
  • Fax: 650-359-3449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE2309
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: