Provider Demographics
NPI:1639176308
Name:BURKHART, CHRIS STEVEN (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:STEVEN
Last Name:BURKHART
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 1:1190 KILKARE RD
Mailing Address - Street 2:
Mailing Address - City:SUNOL
Mailing Address - State:CA
Mailing Address - Zip Code:94586-9408
Mailing Address - Country:US
Mailing Address - Phone:925-200-5076
Mailing Address - Fax:
Practice Address - Street 1:1190 KILKARE RD
Practice Address - Street 2:
Practice Address - City:SUNOL
Practice Address - State:CA
Practice Address - Zip Code:94586-9408
Practice Address - Country:US
Practice Address - Phone:925-200-5076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG30153207Q00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AB6617318OtherDEA
CAHN415ZMedicare PIN