Provider Demographics
NPI:1730401274
Name:BURKHEAD, SVELTLANA PENG (MD)
Entity type:Individual
Prefix:DR
First Name:SVELTLANA
Middle Name:PENG
Last Name:BURKHEAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LANA
Other - Middle Name:
Other - Last Name:BURKHEAD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 8296
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94537-8296
Mailing Address - Country:US
Mailing Address - Phone:510-396-2987
Mailing Address - Fax:
Practice Address - Street 1:4041 LOWRY RD
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94555-1101
Practice Address - Country:US
Practice Address - Phone:510-396-2987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-25
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA75143207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine