Provider Demographics
NPI:1356469266
Name:DRIVER, CATHERINE BURT (MD)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:BURT
Last Name:DRIVER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:26522 LA ALAMEDA
Mailing Address - Street 2:SUITE 120
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6330
Mailing Address - Country:US
Mailing Address - Phone:949-282-1671
Mailing Address - Fax:949-367-0518
Practice Address - Street 1:26732 CROWN VALLEY PKWY STE 151
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6337
Practice Address - Country:US
Practice Address - Phone:949-347-6044
Practice Address - Fax:949-347-6069
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA86522207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A865220Medicaid
CAWA86522AMedicare PIN
CAGW018ZMedicare PIN