Provider Demographics
NPI:1457388613
Name:SLANGER, BURTON (MD)
Entity Type:Individual
Prefix:
First Name:BURTON
Middle Name:
Last Name:SLANGER
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:PO BOX 82337
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93380-2337
Mailing Address - Country:US
Mailing Address - Phone:661-323-5918
Mailing Address - Fax:661-323-4703
Practice Address - Street 1:100 E NORTH ST
Practice Address - Street 2:
Practice Address - City:TAFT
Practice Address - State:CA
Practice Address - Zip Code:93268-3606
Practice Address - Country:US
Practice Address - Phone:661-765-1935
Practice Address - Fax:661-765-1928
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG5018207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000G50180Medicaid
CA00G50182Medicare PIN
CA000G50180Medicaid