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General NPI Number Information
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NPI Number | 1427365576
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Entity Type | Individual
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Provider Name | SHABNAM SHERRI BURKE M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/10/2010
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Last Update Date | 12/27/2021
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Provider Practice Location Address
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Address Line | 400 CRAVEN RD
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City | SAN MARCOS
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State | CA
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Zip | 92078-4201
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Country | US
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Telephone | 877-236-0333
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Fax | 760-510-5495
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Provider Business Mailing Address
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Address Line | 400 CRAVEN RD
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City | SAN MARCOS
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State | CA
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Zip | 92078-4201
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Country | US
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Telephone | 877-236-0333
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Fax | 760-510-5495
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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 | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | A118720
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | A118720
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License Number State | CA
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