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NPI Code Detail

MEDICARE: MS. KATHRYN H. BURNHAM PA

MEDICARE: MS. KATHRYN H. BURNHAM PA
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
1363AM0700XMedical Physician Assistant004734GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1004734OTHERGAPA LICENSE
2PA19398OTHERCACA STATE LICENSE

General Provider Information

NPI Number : 1821058355
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KATHRYN H. BURNHAM PA
Provider Business Mailing Address
First Line : 1700 N ROSE AVE STE 320
Second Line :
City : OXNARD
State : CA
Zip : 93030-7648
Country : US
Telephone Number : 805-485-8709
Fax Number : 805-485-3561
Provider Business Practice Location Address
First Line : 1700 N ROSE AVE STE 320
Second Line :
City : OXNARD
State : CA
Zip : 93030-7648
Country : US
Telephone Number : 805-485-8709
Fax Number : 805-485-3561
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2006
Last Update Date : 10/05/2007

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