Provider Demographics
NPI:1386638153
Name:BURSTEIN, STEVEN (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:BURSTEIN
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:PO BOX 31309
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90031-0309
Mailing Address - Country:US
Mailing Address - Phone:213-977-7422
Mailing Address - Fax:213-250-8945
Practice Address - Street 1:1245 WILSHIRE BLVD STE 580
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-5854
Practice Address - Country:US
Practice Address - Phone:213-977-7422
Practice Address - Fax:213-250-8945
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA049626207RI0011X
CAA49626207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A496260Medicaid
CA060046541OtherMEDICARE RAILROAD
CAWA49626EMedicare ID - Type Unspecified
CA00A496260Medicaid