MEDICARE: EMILY M BURKE

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	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1427915222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY M BURKE

Provider Business Mailing Address
First Line	:	1020 6TH ST APT J
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90403-3982
Country	:	US
Telephone Number	:	508-380-5896
Fax Number	:

Provider Business Practice Location Address
First Line	:	1020 6TH ST APT J
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90403-3982
Country	:	US
Telephone Number	:	508-380-5896
Fax Number	:

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

Provider Enumeration Date	:	01/06/2026
Last Update Date	:	01/06/2026

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