Individual
MARK BURNISTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1020 29TH ST STE 480, SACRAMENTO, CA 95816-5173
(916) 733-3777
(916) 454-6780
Mailing address
10470 OLD PLACERVILLE RD STE 100, SACRAMENTO, CA 95827-2539
(800) 470-0071
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A93054
CA
208M00000X
Hospitalist Physician
Primary
A93054
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000810773563
PHCS
CA
01
—
00A930540
BLUE SHIELD
CA
05
—
00A930540
—
CA
01
—
0263265
CIGNA
CA
01
—
131236
HEALTH NET
CA
01
—
1965271
GREAT WEST
CA
01
—
257707
INTERPLAN
CA
01
—
2671462
UNITED
CA
01
—
5662864
FIRST HEALTH
CA
01
—
7096720
AETNA
CA
01
—
90201430
PACIFICARE
CA
01
—
A93054
BLUE CROSS
CA
01
—
MCMG440900
WESTERN HEALTH ADVANTAGE
CA
Enumeration date
09/20/2006
Last updated
04/10/2018
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