Provider Demographics
NPI:1215915707
Name:BURCH, MIGUEL ANGEL (MD)
Entity type:Individual
Prefix:DR
First Name:MIGUEL
Middle Name:ANGEL
Last Name:BURCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:8700 BEVERLY BLVD, MOT650W
Mailing Address - Street 2:CEDARS-SINAI MEDICAL CENTER
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048
Mailing Address - Country:US
Mailing Address - Phone:310-423-3799
Mailing Address - Fax:310-423-5454
Practice Address - Street 1:8635 W. 3RD ST., SUITE 795W
Practice Address - Street 2:CEDARS-SINAI MEDICAL CENTER
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048
Practice Address - Country:US
Practice Address - Phone:310-423-8350
Practice Address - Fax:310-423-5454
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA87397207K00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA123116Medicare UPIN