Provider Demographics
NPI:1861462335
Name:BURTON, BRUCE T (MD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:T
Last Name:BURTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2415 CAMPUS DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-1527
Mailing Address - Country:US
Mailing Address - Phone:949-999-3600
Mailing Address - Fax:949-999-3648
Practice Address - Street 1:1441 AVOCADO AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7721
Practice Address - Country:US
Practice Address - Phone:949-718-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG42650207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G426500Medicaid
CAWG42650BMedicare PIN
CAA92355Medicare UPIN