Provider Demographics
NPI:1467976340
Name:BURIAN, CHERYL ADELE (MD)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:ADELE
Last Name:BURIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:CHERYL
Other - Middle Name:ADELE
Other - Last Name:BURIAN-BALDWIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:6572 CASCADE ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92122-2425
Mailing Address - Country:US
Mailing Address - Phone:858-455-7346
Mailing Address - Fax:
Practice Address - Street 1:6572 CASCADE ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92122-2425
Practice Address - Country:US
Practice Address - Phone:858-455-7346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-01
Last Update Date:2017-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG28525208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics