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General NPI Number Information
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NPI Number | 1306245386
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Entity Type | Organization
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Legal Business Name | BURBANK PLASTIC SURGERY MEDICAL GROUP
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Dates
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Enumeration Date | 08/15/2014
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Last Update Date | 08/22/2014
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Provider Practice Location Address
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Address Line | 2301 W ALAMEDA AVE
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City | BURBANK
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State | CA
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Zip | 91506
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Country | US
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Telephone | 818-848-0590
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Fax | 818-848-3574
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Provider Business Mailing Address
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Address Line | 2301 W ALAMEDA AVE
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City | BURBANK
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State | CA
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Zip | 91506
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Country | US
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Telephone | 818-848-0590
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Fax | 818-848-3574
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. BLANKA ORLOFF
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Credential | M.D.
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Telephone | 818-848-0590
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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 |
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