Individual
VIVIEN K BURT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
300 MEDICAL PLZ, LOS ANGELES, CA 90095-0001
(310) 825-9989
Mailing address
FILE 2939, LOS ANGELES, CA 90074-0001
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
G55895
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G558950
MEDI CAL
CA
Enumeration date
07/15/2006
Last updated
07/08/2007
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