Individual
ANDREW KELLY BURT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
77 MARK DR STE 25, SAN RAFAEL, CA 94903-2268
(415) 491-1492
(415) 419-1499
Mailing address
77 MARK DR STE 25, SAN RAFAEL, CA 94903-2268
(415) 491-1492
(415) 419-1499
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
C383160
CA
Other
Enumeration date
03/28/2007
Last updated
07/08/2007
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