MEDICARE: DR. EMIRO BURBANO M.D.

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	207R00000X	Internal Medicine Physician	A32671	CA
2	207RP1001X	Pulmonary Disease Physician	A32671	CA

General Provider Information

NPI Number	:	1790752293
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EMIRO BURBANO M.D.

Provider Business Mailing Address
First Line	:	2112B MCKEE RD
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95116-1427
Country	:	US
Telephone Number	:	408-258-5864
Fax Number	:	408-272-5864

Provider Business Practice Location Address
First Line	:	2112B MCKEE RD
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95116-1427
Country	:	US
Telephone Number	:	408-258-5864
Fax Number	:	408-272-5864

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

Provider Enumeration Date	:	03/02/2006
Last Update Date	:	04/09/2008

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