Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | ||
N | 222Z00000X | Podiatrist | ||
Y | 224P00000X | Prosthetist |
NPI | 1053508861 |
---|---|
Provider Name | Paul F Burnette |
First Address | Fremont, CA 94538-2268 |
Second Address | Fremont, CA 94538-2268 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2007 |
Last Update Date | 26/09/2007 |