Provider Demographics
NPI:1851360168
Name:BURNHAM, JOHN C (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:C
Last Name:BURNHAM
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 1:1720 ESPLANADE
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-3315
Mailing Address - Country:US
Mailing Address - Phone:530-898-0504
Mailing Address - Fax:530-898-9647
Practice Address - Street 1:1702 ESPLANADE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-3315
Practice Address - Country:US
Practice Address - Phone:530-898-0500
Practice Address - Fax:530-898-9647
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARHL 1164982085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G261200Medicaid
CAG26120OtherMEDICAL LICENSE
CAG26120OtherMEDICAL LICENSE
CA00G261200Medicaid