Provider Demographics
NPI:1063469005
Name:NORRIS, DORA BURCHETTE (MD)
Entity Type:Individual
Prefix:DR
First Name:DORA
Middle Name:BURCHETTE
Last Name:NORRIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DORA
Other - Middle Name:MARIA
Other - Last Name:BURCHETTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:39115 TRADE CENTER DR STE 130
Mailing Address - Street 2:SIERRA MEDICAL GROUP
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-3649
Mailing Address - Country:US
Mailing Address - Phone:661-273-0100
Mailing Address - Fax:661-273-5812
Practice Address - Street 1:39115 TRADE CENTER DR STE 130
Practice Address - Street 2:SIERRA MEDICAL GROUP
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-3649
Practice Address - Country:US
Practice Address - Phone:661-273-0100
Practice Address - Fax:661-273-5812
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-27
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG55748208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G557480Medicaid