MEDICARE: DARRYL E BURNS DPM PC

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	213E00000X	Podiatrist	E2225	CA
2	213EP1101X	Primary Podiatric Medicine Podiatrist	E2225	CA
3	213ES0000X	Sports Medicine Podiatrist	E2225	CA
4	213ES0103X	Foot & Ankle Surgery Podiatrist	E2225	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ZZZ26607Z	OTHER	CA	MEDICARE CORP#

General Provider Information

NPI Number	:	1831326198
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DARRYL E BURNS DPM PC

Provider Business Mailing Address
First Line	:	880 CASS ST
Second Line	:	SUITE 103
City	:	MONTEREY
State	:	CA
Zip	:	93940-2947
Country	:	US
Telephone Number	:	831-646-0442
Fax Number	:	831-372-3774

Provider Business Practice Location Address
First Line	:	880 CASS ST
Second Line	:	SUITE 103
City	:	MONTEREY
State	:	CA
Zip	:	93940-2947
Country	:	US
Telephone Number	:	831-646-0442
Fax Number	:	831-372-3774

Authorized Official
Title or Position	:	PODIATRIST
Name	:	DR. DARRYL E BURNS
Credential	:	DPM
Telephone Number	:	831-646-0442

Provider Enumeration Date	:	06/15/2009
Last Update Date	:	06/15/2009

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Directions to “DARRYL E BURNS DPM PC ” Practice Location

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