Provider Demographics
NPI:1770058083
Name:BURBANK, ANDREA DAWN (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:DAWN
Last Name:BURBANK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANDREA
Other - Middle Name:DAWN
Other - Last Name:PINNEGAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:37 LOST VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:ORINDA
Mailing Address - State:CA
Mailing Address - Zip Code:94563-3928
Mailing Address - Country:US
Mailing Address - Phone:650-387-6648
Mailing Address - Fax:
Practice Address - Street 1:7703 FLOYD CURL DR # MC7742
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3901
Practice Address - Country:US
Practice Address - Phone:210-567-2032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-12
Last Update Date:2018-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program