Provider Demographics
NPI:1538215439
Name:BURATTI, DAWN RUTH (DPM)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:RUTH
Last Name:BURATTI
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19231 VICTORY BLVD STE 550
Mailing Address - Street 2:
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-6382
Mailing Address - Country:US
Mailing Address - Phone:818-701-6300
Mailing Address - Fax:818-217-1940
Practice Address - Street 1:19231 VICTORY BLVD STE 550
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-6382
Practice Address - Country:US
Practice Address - Phone:818-701-6300
Practice Address - Fax:818-217-1940
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4170213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E41700Medicaid
CAE4170Medicare ID - Type Unspecified
CAU72485Medicare UPIN
CAE4170Medicare PIN