Provider Demographics
NPI:1548348097
Name:BURKLEE, ELIZABETH ANNE (DC)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ANNE
Last Name:BURKLEE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 DOVER DR
Mailing Address - Street 2:SUIT 122
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-5538
Mailing Address - Country:US
Mailing Address - Phone:949-574-9390
Mailing Address - Fax:949-574-9316
Practice Address - Street 1:901 DOVER DR
Practice Address - Street 2:SUIT 122
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-5538
Practice Address - Country:US
Practice Address - Phone:949-574-9390
Practice Address - Fax:949-574-9316
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27314111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC27314OtherCHIROPRACTIC LICENSE NO.