Individual
MRS. MARY ANN BURKE
Active
Individual
MRS. MARY ANN BURKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPT
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
PT16770
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GPT001411
—
CA
01
—
OPT16770
BLUE SHIELD
CA
01
—
PT16770
BLUE CROSS
CA
Enumeration date
12/05/2006
Last updated
09/04/2012
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