Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0201X | Pediatric Allergist | A20118 | CA |
NPI | 1285103440 |
---|---|
Provider Name | Alan Philip Burckin |
First Address | Walnut Creek, CA 94597-2545 |
Second Address | Walnut Creek, CA 94597-2545 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2018 |
Last Update Date | 17/11/2018 |