MEDICARE: MS. SUSAN E BURGER F.N.P

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	363LW0102X	Women's Health Nurse Practitioner	284738	CA

General Provider Information

NPI Number	:	1245389287
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SUSAN E BURGER F.N.P

Provider Business Mailing Address
First Line	:	22110 ROSCOE BLVD
Second Line	:	SUITE 104
City	:	WEST HILLS
State	:	CA
Zip	:	91304-3845
Country	:	US
Telephone Number	:	818-704-6696
Fax Number	:	818-704-6896

Provider Business Practice Location Address
First Line	:	22110 ROSCOE BLVD
Second Line	:	SUITE 104
City	:	WEST HILLS
State	:	CA
Zip	:	91304-3845
Country	:	US
Telephone Number	:	818-704-6696
Fax Number	:	818-704-6896

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

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	07/08/2007

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