Individual
CHARLES PARK BURCHETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5820 YOLANDA AVE APT 8, TARZANA, CA 91356-1450
(818) 404-8336
Mailing address
5820 YOLANDA AVE APT 8, TARZANA, CA 91356-1450
(818) 404-8336
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
716149
CA
Other
Enumeration date
05/05/2011
Last updated
12/03/2021
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