Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | A87397 | CA |
Y | 208200000X | Surgeon | A87397 | CA |
Y | 208600000X | Surgeon | A87397 | CA |
NPI | 1215915707 |
---|---|
Provider Name | Dr. Miguel Angel Burch |
First Address | Los Angeles, CA 90048 |
Second Address | Los Angeles, CA 90048 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2006 |
Last Update Date | 24/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
123116 | (02) | CA |