Individual
DR. CAROL MARIE BURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3132 W MARCH LN STE 5, STOCKTON, CA 95219-2354
(209) 475-5500
(209) 475-5535
Mailing address
3400 DATA DR, ATTN CREDENTIALING/PAYER ENROLLMENT, RANCHO CORDOVA, CA 95670
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G76903
CA
Other
Enumeration date
07/18/2006
Last updated
06/16/2021
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