MEDICARE: MAKIYA BURKE

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	172V00000X	Community Health Worker		CA

General Provider Information

NPI Number	:	1922940501
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAKIYA BURKE

Provider Business Mailing Address
First Line	:	11616 CRENSHAW BLVD APT 4
Second Line	:
City	:	INGLEWOOD
State	:	CA
Zip	:	90303-3270
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12021 WILMINGTON AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90059-3019
Country	:	US
Telephone Number	:	424-454-6041
Fax Number	:

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

Provider Enumeration Date	:	04/06/2026
Last Update Date	:	04/06/2026

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Directions to “ MAKIYA BURKE ” Practice Location

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