Provider Demographics
NPI:1659566826
Name:BURNS, JOHN W III (CP)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:W
Last Name:BURNS
Suffix:III
Gender:M
Credentials:CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 NEVADA ST STE 206
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-8051
Mailing Address - Country:US
Mailing Address - Phone:909-792-1900
Mailing Address - Fax:
Practice Address - Street 1:721 NEVADA ST STE 206
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-8051
Practice Address - Country:US
Practice Address - Phone:909-792-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist