Basic Information
| Provider Information | |||||||||
| NPI: | 1891722658 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BURNEY | ||||||||
| FirstName: | BRIAN | ||||||||
| MiddleName: | WILLIAM | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1309 W 35TH ST | ||||||||
| Address2: | |||||||||
| City: | SAN PEDRO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 907316005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3105475782 | ||||||||
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| Practice Location | |||||||||
| Address1: | 850S ATLANTIC BLVD 201 | ||||||||
| Address2: | |||||||||
| City: | MONTEREY PARK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917546705 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6262892894 | ||||||||
| FaxNumber: | 9512966741 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2006 | ||||||||
| LastUpdateDate: | 09/24/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | NA2088 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.