Provider Demographics
NPI:1629170048
Name:BURNS, DAVID B (NP)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:B
Last Name:BURNS
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9850 GENESEE AVENUE
Mailing Address - Street 2:#940
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037
Mailing Address - Country:US
Mailing Address - Phone:858-658-0020
Mailing Address - Fax:858-658-0084
Practice Address - Street 1:9850 GENESEE AVENUE
Practice Address - Street 2:#940
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037
Practice Address - Country:US
Practice Address - Phone:858-658-0020
Practice Address - Fax:858-658-0084
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA301074363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA301074OtherBOARD OF REGISTERED NURS