MEDICARE: PATRICIA BURSON DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	308148	CA

General Provider Information

NPI Number	:	1174413223
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA BURSON DPT

Provider Business Mailing Address
First Line	:	6909 E ESPANITA ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90815-4820
Country	:	US
Telephone Number	:	562-522-6740
Fax Number	:

Provider Business Practice Location Address
First Line	:	590 S FAIR OAKS AVE STE 110
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91105-2614
Country	:	US
Telephone Number	:	818-369-7620
Fax Number	:	818-369-7621

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2025
Last Update Date	:	06/16/2026

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