Provider Demographics
NPI:1255489050
Name:BURKES, JOSEPH B (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:B
Last Name:BURKES
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 1:714 F ST
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-1036
Mailing Address - Country:US
Mailing Address - Phone:707-442-5335
Mailing Address - Fax:707-442-1452
Practice Address - Street 1:714 F ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-1036
Practice Address - Country:US
Practice Address - Phone:707-442-5335
Practice Address - Fax:707-442-1452
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG35116207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G351160Medicaid
A91662Medicare UPIN