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General NPI Number Information
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NPI Number | 1386833796
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Entity Type | Individual
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Provider Name | TJERK F BURY MD
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Gender | Male
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Dates
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Enumeration Date | 10/22/2007
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Last Update Date | 10/22/2007
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Provider Practice Location Address
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Address Line | 351 ROLLING OAKS DR STE 203
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City | THOUSAND OAKS
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State | CA
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Zip | 91361-1268
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Country | US
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Telephone | 805-777-7333
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Fax | 805-777-7330
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Provider Business Mailing Address
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Address Line | 351 ROLLING OAKS DR STE 203
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City | THOUSAND OAKS
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State | CA
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Zip | 91361-1268
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Country | US
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Telephone | 805-777-7333
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Fax | 805-777-7330
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2082S0105X
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Taxonomy Name | Surgery of the Hand (Plastic Surgery) Physician
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License Number | A48602
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License Number State | CA
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