MEDICARE: DR. BRUCE T BURTON 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	207L00000X	Anesthesiology Physician	G42650	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861462335
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRUCE T BURTON M.D.

Provider Business Mailing Address
First Line	:	2415 CAMPUS DR
Second Line	:	SUITE 110
City	:	IRVINE
State	:	CA
Zip	:	92612-1527
Country	:	US
Telephone Number	:	949-999-3600
Fax Number	:	949-999-3648

Provider Business Practice Location Address
First Line	:	1441 AVOCADO AVE
Second Line	:	SUITE 103
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-7721
Country	:	US
Telephone Number	:	949-718-3600
Fax Number	:

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

Provider Enumeration Date	:	01/25/2006
Last Update Date	:	02/11/2010

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