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General NPI Number Information
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NPI Number | 1255648143
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Entity Type | Organization
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Legal Business Name | MICHAEL D. BURDI, M.D. INC
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Dates
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Enumeration Date | 09/13/2010
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Last Update Date | 09/13/2010
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Provider Practice Location Address
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Address Line | 26401 CROWN VALLEY PKWY STE 101
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City | MISSION VIEJO
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State | CA
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Zip | 92691-6302
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Country | US
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Telephone | 949-315-5387
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Fax |
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Provider Business Mailing Address
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Address Line | 26401 CROWN VALLEY PKWY STE 101
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City | MISSION VIEJO
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State | CA
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Zip | 92691-6302
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Country | US
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Telephone | 949-315-5387
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. MICHAEL D. BURDI
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Credential | MD
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Telephone | 949-315-5387
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | A70607
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License Number State | CA
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