Provider Demographics
NPI:1871546291
Name:BURKE, BRUCE LEMONT (MD)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:LEMONT
Last Name:BURKE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1531 ESPLANADE
Mailing Address - Street 2:ATTN: FINANCE
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-3310
Mailing Address - Country:US
Mailing Address - Phone:530-332-7479
Mailing Address - Fax:530-893-6853
Practice Address - Street 1:251 COHASSET RD
Practice Address - Street 2:SUITE 370
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2241
Practice Address - Country:US
Practice Address - Phone:530-895-3333
Practice Address - Fax:530-895-3217
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2014-03-19
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Provider Licenses
StateLicense IDTaxonomies
CAA23436207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A234360Medicaid
CA140006655OtherRR MEDICARE
CAA23539Medicare UPIN
CA00A234360Medicaid