Provider Demographics
NPI:1225720790
Name:CTSH BURBANK, LLC
Entity Type:Organization
Organization Name:CTSH BURBANK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:PARKER
Authorized Official - Middle Name:
Authorized Official - Last Name:WELLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-264-3447
Mailing Address - Street 1:640 N TUSTIN AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-3783
Mailing Address - Country:US
Mailing Address - Phone:949-916-6705
Mailing Address - Fax:949-916-6785
Practice Address - Street 1:611 N BRAND BLVD STE 1300
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-3213
Practice Address - Country:US
Practice Address - Phone:818-446-6966
Practice Address - Fax:949-916-6785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-23
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care