Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist |
NPI | 1154452688 |
---|---|
Provider Name | Dr. Robert Burton |
First Address | Anaheim, CA 92804-3729 |
Second Address | Anaheim, CA 92804-3729 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A43705 | PHYSICIAN AND SURGEON (01) | CA |