Provider Demographics
NPI:1831326198
Name:DARRYL E BURNS DPM PC
Entity type:Organization
Organization Name:DARRYL E BURNS DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DARRYL
Authorized Official - Middle Name:E
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:831-646-0442
Mailing Address - Street 1:880 CASS ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-2947
Mailing Address - Country:US
Mailing Address - Phone:831-646-0442
Mailing Address - Fax:831-372-3774
Practice Address - Street 1:880 CASS ST
Practice Address - Street 2:SUITE 103
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-2947
Practice Address - Country:US
Practice Address - Phone:831-646-0442
Practice Address - Fax:831-372-3774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-15
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE2225213E00000X, 213EP1101X, 213ES0000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ26607ZOtherMEDICARE CORP#
CA000E22250Medicare UPIN
CAT11234Medicare UPIN
CA4934800001Medicare NSC