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General NPI Number Information
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NPI Number | 1174359061
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Entity Type | Organization
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Legal Business Name | CRITICAL CARE CONSULTANTS OF BURBANK INC.
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Dates
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Enumeration Date | 09/09/2024
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 501 S BUENA VISTA ST
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City | BURBANK
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State | CA
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Zip | 91505-4809
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Country | US
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Telephone | 818-842-4819
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Fax | 818-842-8551
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Provider Business Mailing Address
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Address Line | 201 S BUENA VISTA ST STE 440
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City | BURBANK
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State | CA
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Zip | 91505-4577
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Country | US
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Telephone | 818-842-4819
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Fax | 818-842-8551
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Authorized Official
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Title or Position | MANAGER
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Name | SHERI ROBERTS
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Credential |
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Telephone | 818-606-6861
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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