Provider Demographics
NPI:1629825914
Name:BURGER PEDIATRIC CENTER
Entity type:Organization
Organization Name:BURGER PEDIATRIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PATIENT SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:ARIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BURGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-983-5915
Mailing Address - Street 1:PO BOX 1100
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95763-1100
Mailing Address - Country:US
Mailing Address - Phone:916-983-5915
Mailing Address - Fax:
Practice Address - Street 1:1301 E BIDWELL ST STE 201
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-3565
Practice Address - Country:US
Practice Address - Phone:916-983-5915
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BURGER PHYSICAL THERAPY AND REHABILITATION AGENCY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-05-03
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy