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Individual

BRANDON A BURK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
39000 BOB HOPE DR DEPT OF, RANCHO MIRAGE, CA 92270-3221
(760) 773-1251
(800) 409-7005
Mailing address
PO BOX 280, HOUSE STAFF OFFICE CP 21005, RANCHO MIRAGE, CA 92270-0280
(760) 340-3911
(800) 409-7005

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A110173
CA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00A1101730
BC/BS OF CA
CA
05
1568634509
CA
Enumeration date
03/31/2008
Last updated
08/28/2014
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