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NPI Code Detail

MEDICARE: BURTON BIALIK PH.D., MFT

MEDICARE:   BURTON  BIALIK  PH.D., MFT
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
1106H00000XMarriage & Family TherapistMFC20771CA

General Provider Information

NPI Number : 1639233018
Entity Type Code : Individual
Provider Name (Legal Business Name) : BURTON BIALIK PH.D., MFT
Provider Business Mailing Address
First Line : 4036 VISTA CALAVERAS ST
Second Line :
City : OCEANSIDE
State : CA
Zip : 92056-4606
Country : US
Telephone Number : 760-435-9355
Fax Number : 760-806-7721
Provider Business Practice Location Address
First Line : 2125 S EL CAMINO REAL STE 206
Second Line :
City : OCEANSIDE
State : CA
Zip : 92054-6260
Country : US
Telephone Number : 760-435-9355
Fax Number : 760-806-7721
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2006
Last Update Date : 02/09/2012

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Directions to “ BURTON BIALIK PH.D., MFT” Practice Location

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