Provider Demographics
NPI:1053300798
Name:ROY-BURMAN, ARUP (MD)
Entity Type:Individual
Prefix:DR
First Name:ARUP
Middle Name:
Last Name:ROY-BURMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 PARNASSUS AVE
Mailing Address - Street 2:M680
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-0106
Mailing Address - Country:US
Mailing Address - Phone:415-476-5153
Mailing Address - Fax:415-502-4186
Practice Address - Street 1:505 PARNASSUS AVE
Practice Address - Street 2:M680
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-0106
Practice Address - Country:US
Practice Address - Phone:415-476-5153
Practice Address - Fax:415-502-4186
Is Sole Proprietor?:No
Enumeration Date:2005-10-15
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA548282080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A548280Medicaid
CA00A548280Medicaid