Provider Demographics
NPI:1356392716
Name:BURNS, ALBERT E
Entity type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:E
Last Name:BURNS
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 1:669 CRESPI DR
Mailing Address - Street 2:
Mailing Address - City:PACIFICA
Mailing Address - State:CA
Mailing Address - Zip Code:94044-3486
Mailing Address - Country:US
Mailing Address - Phone:650-359-7770
Mailing Address - Fax:650-359-3449
Practice Address - Street 1:669 CRESPI DR
Practice Address - Street 2:
Practice Address - City:PACIFICA
Practice Address - State:CA
Practice Address - Zip Code:94044-3486
Practice Address - Country:US
Practice Address - Phone:650-359-7770
Practice Address - Fax:650-359-3449
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE2309213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00E230900Medicaid
CA000E23090Medicare ID - Type Unspecified
CA00E230900Medicaid