Healthcare Provider Details

I. General information

NPI: 1437248572
Provider Name (Legal Business Name): MICHELE IRENE BURNS PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 07/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 W. SUNFLOWER AVE SUITE 250
SANTA ANA CA
92704
US

IV. Provider business mailing address

3401 W. SUNFLOWER AVE SUITE 250
SANTA ANA CA
92704
US

V. Phone/Fax

Practice location:
  • Phone: 714-619-8777
  • Fax: 714-619-8770
Mailing address:
  • Phone: 714-619-8777
  • Fax: 714-619-8770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number16023
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: