Provider Demographics
NPI:1659470367
Name:BURBANK PODIATRY ASSCOCIATES GROUP A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:BURBANK PODIATRY ASSCOCIATES GROUP A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FRANKLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KASE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:818-848-5583
Mailing Address - Street 1:241 W OLIVE AVE
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91502-1825
Mailing Address - Country:US
Mailing Address - Phone:818-848-5583
Mailing Address - Fax:818-848-1872
Practice Address - Street 1:241 W OLIVE AVE
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91502-1825
Practice Address - Country:US
Practice Address - Phone:818-848-5583
Practice Address - Fax:818-848-1487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2014-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1074160001Medicare NSC
CAWE5786Medicare PIN