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Organization
KIETH J. BURKART, O.D., A PROFESSIONAL CORPORATION
Active
Organization
KIETH J. BURKART, O.D., A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIETH J BURKART O.D. (PRESIDENT)
(909) 337-4310
Entity
Organization
Contact information
Practice address
29099 HOSPITAL RD, SUITE 205, LAKE ARROWHEAD, CA 92352-2226
(909) 337-4310
(909) 336-5937
Mailing address
PO BOX 2226, LAKE ARROWHEAD, CA 92352-2226
(909) 337-4310
(909) 336-5937
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
COR1096
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0056390
—
CA
Enumeration date
08/24/2006
Last updated
06/11/2019
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