Individual
CI EN GAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1311 N SAN FERNANDO BLVD, BURBANK, CA 91504-4236
(818) 843-9900
Mailing address
1311 N SAN FERNANDO BLVD, BURBANK, CA 91504-4236
(818) 843-9900
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20A17614
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/17/2018
Last updated
12/06/2021
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