Healthcare Provider Details

I. General information

NPI: 1063469005
Provider Name (Legal Business Name): DORA BURCHETTE NORRIS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DORA MARIA BURCHETTE M.D.

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 12/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39115 TRADE CENTER DR STE 130 SIERRA MEDICAL GROUP
PALMDALE CA
93551-3649
US

IV. Provider business mailing address

39115 TRADE CENTER DR STE 130 SIERRA MEDICAL GROUP
PALMDALE CA
93551-3649
US

V. Phone/Fax

Practice location:
  • Phone: 661-273-0100
  • Fax: 661-273-5812
Mailing address:
  • Phone: 661-273-0100
  • Fax: 661-273-5812

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG55748
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: