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General NPI Number Information
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NPI Number | 1710377296
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Entity Type | Organization
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Legal Business Name | BURBANK BRACHYTHERAPY INSTITUTE INC
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Dates
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Enumeration Date | 02/04/2015
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Last Update Date | 02/04/2015
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Provider Practice Location Address
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Address Line | 2601 W ALAMEDA AVE SUITE 300
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City | BURBANK
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State | CA
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Zip | 91505-4800
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Country | US
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Telephone | 818-588-3840
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Fax |
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Provider Business Mailing Address
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Address Line | 2601 W ALAMEDA AVE SUITE 300
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City | BURBANK
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State | CA
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Zip | 91505-4800
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Country | US
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Telephone | 818-588-3840
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | RANDALL A SCHARLACH
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Credential | MD
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Telephone | 818-449-2700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | A19697
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License Number State | CA
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