Organization
BURBANK EMERGENCY MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN EDWARD KISHINEFF MD (PRESIDENT)
(818) 847-4055
Entity
Organization
Contact information
Practice address
501 S BUENA VISTA ST, EM DEPT, BURBANK, CA 91505-4809
(818) 843-5111
Mailing address
501 S BUENA VISTA ST, BURBANK, CA 91505-4809
(818) 847-4055
(818) 848-4320
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D0971295
CLIA WAIVER
—
01
—
2956715
MEDI CAL AEVS
—
01
—
C41068
RAIL ROAD MEDICARE
—
01
—
N49
CALOPTIMA
—
01
—
ZZZ72788Z
BLUE SHIELD
—
Enumeration date
04/04/2006
Last updated
07/09/2024
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us