Individual
MR. BURNETT EUGENE ANCRUM I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CASE COORDINATOR
Contact information
Practice address
340 N MADISON AVE, LOS ANGELES, CA 90004-3504
(323) 644-2026
Mailing address
1906 W 3RD ST, LOS ANGELES, CA 90057-2304
(323) 644-2026
(323) 644-2039
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
03/01/2007
Last updated
09/30/2010
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