Most Relevant Information
Provider Data
| NPI Number: | 1003589144 |
| Provider Name: | KASEY BURNSIDE PNP-PC |
| Entity Type: | Individual |
| Taxonomy Code: | 2080P0207X |
| Specialty: | Pediatrics |
| License Number: | 95017790 |
Most Important Dates
| Enumeration Date: | 07/26/2021 |
| Last Updated: | 07/26/2021 |
Provider Practice Location
4650 W SUNSET BLVD
LOS ANGELES
CA
900276062
Practice Location Phone/Fax
| Phone: | 3233616620 |
| Fax: |
Provider Mailing Location
4650 W SUNSET BLVD
LOS ANGELES
CA
900276062
Provider Mailing Phone/Fax
| Phone: | 3233616620 |
| Fax: |