MEDICARE: PHILLIP A BURNEY AUD

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	237600000X	Audiologist-Hearing Aid Fitter	AU248	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346411543
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHILLIP A BURNEY AUD

Provider Business Mailing Address
First Line	:	1005 N PALM CYN DR
Second Line	:
City	:	PALM SPRINGS
State	:	CA
Zip	:	92262-4419
Country	:	US
Telephone Number	:	760-323-8405
Fax Number	:	760-323-8723

Provider Business Practice Location Address
First Line	:	1005 N PALM CANYON DR
Second Line	:
City	:	PALM SPRINGS
State	:	CA
Zip	:	92262-4419
Country	:	US
Telephone Number	:	760-323-8405
Fax Number	:	760-323-8723

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

Provider Enumeration Date	:	03/14/2008
Last Update Date	:	10/06/2009

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Directions to “ PHILLIP A BURNEY AUD” Practice Location

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