Provider Demographics
NPI:1841218583
Name:NORTHSTATE NEUROSURGICAL ASSOCIATES
Entity Type:Organization
Organization Name:NORTHSTATE NEUROSURGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:L
Authorized Official - Last Name:BURKE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:530-895-3333
Mailing Address - Street 1:251 COHASSET RD
Mailing Address - Street 2:SUITE 370
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-2276
Mailing Address - Country:US
Mailing Address - Phone:530-895-3333
Mailing Address - Fax:530-895-3217
Practice Address - Street 1:251 COHASSET RD
Practice Address - Street 2:SUITE 370
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2276
Practice Address - Country:US
Practice Address - Phone:530-895-3333
Practice Address - Fax:530-895-3217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACG7710OtherRR MEDICARE
CAGR0087370Medicaid
CAGR0087370Medicaid