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Individual

BURNETT RUCKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2615 EYE ST, BAKERSFIELD, CA 93301-2006
(661) 395-3000
(661) 323-4703
Mailing address
PO BOX 82396, BAKERSFIELD, CA 93380-2396
(661) 323-5918
(661) 323-4703

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A34349
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A343490
CA
01
CM536Z
MEDICARE PIN - WSUC
CA
Enumeration date
08/08/2006
Last updated
12/21/2009
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