Provider Demographics
NPI:1245343946
Name:BURLIN, JOSEPH R (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:R
Last Name:BURLIN
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 1:1805 N CALIFORNIA ST
Mailing Address - Street 2:SUITE 405
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95204-6037
Mailing Address - Country:US
Mailing Address - Phone:209-870-7100
Mailing Address - Fax:209-870-7116
Practice Address - Street 1:1805 N CALIFORNIA ST
Practice Address - Street 2:SUITE 405
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95204-6037
Practice Address - Country:US
Practice Address - Phone:209-870-7100
Practice Address - Fax:209-870-7116
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2017-09-15
Deactivation Date:2017-08-23
Deactivation Code:
Reactivation Date:2017-09-15
Provider Licenses
StateLicense IDTaxonomies
CAG035291208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery