Healthcare Provider Details

I. General information

NPI: 1063044337
Provider Name (Legal Business Name): KIRSTEEN RENNIE BURTON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2020
Last Update Date: 02/23/2021
Certification Date: 02/23/2021
Deactivation Date: 12/08/2020
Reactivation Date: 02/23/2021

III. Provider practice location address

UCSF DEPT. OF RADIOLOGY & BIOMEDICAL IMAGING 513 PARNASSUS AVENUE
SAN FRANCISCO CA
90103-0028
US

IV. Provider business mailing address

111 ST. CLAIR AVENUE WEST, SUITE 1605
TORONTO ONTARIO
M4V1N5
CA

V. Phone/Fax

Practice location:
  • Phone: 415-476-1575
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number137416
License Number StateZZ
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberA158430
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: