Healthcare Provider Details

I. General information

NPI: 1285103440
Provider Name (Legal Business Name): ALAN PHILIP BURCKIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/17/2018
Last Update Date: 11/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1882 3RD AVE
WALNUT CREEK CA
94597-2545
US

IV. Provider business mailing address

1882 3RD AVE
WALNUT CREEK CA
94597-2545
US

V. Phone/Fax

Practice location:
  • Phone: 925-945-6750
  • Fax:
Mailing address:
  • Phone: 925-945-6750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0201X
TaxonomyPediatric Allergy/Immunology Physician
License NumberA20118
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: