Provider Demographics
NPI:1780181230
Name:BURDICK, BRITTANY VASAE LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:BRITTANY VASAE
Middle Name:LYNN
Last Name:BURDICK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:LYNN
Other - Last Name:BURDICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1000 W CARSON ST # 8
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90502-2004
Mailing Address - Country:US
Mailing Address - Phone:310-222-3137
Mailing Address - Fax:
Practice Address - Street 1:1000 W CARSON ST # 8
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-2004
Practice Address - Country:US
Practice Address - Phone:424-306-5807
Practice Address - Fax:310-328-7212
Is Sole Proprietor?:No
Enumeration Date:2018-04-11
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA163369174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist