Individual
MR. EDDIE REGINALD BURSTON II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12727 CAMINO EMPARRADO, SAN DIEGO, CA 92128
(858) 265-9992
(858) 798-5221
Mailing address
19612 VILLA CT EHS7, SOUTHFIELD, MI 48076
(858) 265-9992
(858) 798-5221
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
7516084757
CA
253Z00000X
In Home Supportive Care Agency
B8163X
MI
Other
Enumeration date
05/24/2018
Last updated
05/24/2018
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