Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0505X | Family Doctor - Adult Medicine | A73155 | CO |
NPI | 1285712927 |
---|---|
Provider Name | Arlene R. Burton |
First Address | Oakland, CA 94612-3466 |
Second Address | Elk Grove, CA 95758-1240 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 10/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A731550 | (05) | CA |