Provider Demographics
NPI:1255320438
Name:BURTON, ALLISON (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:
Last Name:BURTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2350 BUHNE ST
Mailing Address - Street 2:A
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-3238
Mailing Address - Country:US
Mailing Address - Phone:707-443-4593
Mailing Address - Fax:707-443-6447
Practice Address - Street 1:2350 BUHNE ST
Practice Address - Street 2:A
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-3238
Practice Address - Country:US
Practice Address - Phone:707-443-4593
Practice Address - Fax:707-443-6447
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA839110173000000X, 207Q00000X
CAA83911207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A839110Medicaid
CAZZZ36729ZMedicare ID - Type Unspecified
CAH91779Medicare UPIN