Provider Demographics
NPI:1134381924
Name:BURGIN, EDWARD ARNOLD
Entity type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:ARNOLD
Last Name:BURGIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:955 43RD AVE
Mailing Address - Street 2:APT 124
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95831-1382
Mailing Address - Country:US
Mailing Address - Phone:510-798-9130
Mailing Address - Fax:
Practice Address - Street 1:444 N 3RD ST
Practice Address - Street 2:SUITE 230
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95811
Practice Address - Country:US
Practice Address - Phone:916-264-0243
Practice Address - Fax:916-264-0255
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-02
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)