Provider Demographics
NPI:1205994696
Name:BURKE, ROBERT CHRISTOPHER (PT)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:CHRISTOPHER
Last Name:BURKE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4820 DEL ORO PL
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93033-7530
Mailing Address - Country:US
Mailing Address - Phone:805-758-0604
Mailing Address - Fax:
Practice Address - Street 1:4572 TELEPHONE RD
Practice Address - Street 2:SUITE 903
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-5662
Practice Address - Country:US
Practice Address - Phone:805-654-8127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist