Individual
KEITH R BURNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4200 E PCH, LONG BEACH, CA 90804-2107
(949) 784-2303
Mailing address
PO BOX 91689, LONG BEACH, CA 90809-1689
(949) 784-2303
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G40959
CA
Other
Enumeration date
03/30/2006
Last updated
09/25/2015
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