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General NPI Number Information
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NPI Number | 1114473972
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Entity Type | Organization
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Legal Business Name | BURBANK SPINE AND PAIN SURGERY CENTER A PROFESSIONAL MEDICAL CORP
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Dates
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Enumeration Date | 08/31/2016
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 2211 W MAGNOLIA BLVD SUITE 270
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City | BURBANK
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State | CA
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Zip | 91506-1753
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Country | US
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Telephone | 818-325-2088
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Fax | 818-563-6201
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Provider Business Mailing Address
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Address Line | 2211 W MAGNOLIA BLVD STE 270
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City | BURBANK
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State | CA
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Zip | 91506-1756
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Country | US
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Telephone | 818-325-2088
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Fax | 818-563-6201
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | KARRIE SIMONIAN
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Credential |
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Telephone | 818-588-4150
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State | CA
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