Provider Demographics
NPI:1184025629
Name:BURGER, ANGELA (IBCLC)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:BURGER
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 GRAND BLVD
Mailing Address - Street 2:2
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-5104
Mailing Address - Country:US
Mailing Address - Phone:650-235-0007
Mailing Address - Fax:
Practice Address - Street 1:232 GRAND BLVD
Practice Address - Street 2:2
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-5104
Practice Address - Country:US
Practice Address - Phone:650-235-0007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-15
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN