Provider Demographics
NPI:1992815328
Name:BURTON, VAL CORDELL (DC, HEARING AID DI)
Entity type:Individual
Prefix:DR
First Name:VAL
Middle Name:CORDELL
Last Name:BURTON
Suffix:
Gender:M
Credentials:DC, HEARING AID DI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:717 SANTA MONICA BLVD
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90401-2601
Mailing Address - Country:US
Mailing Address - Phone:310-451-0848
Mailing Address - Fax:818-360-4200
Practice Address - Street 1:717 SANTA MONICA BLVD
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90401-2601
Practice Address - Country:US
Practice Address - Phone:310-451-0848
Practice Address - Fax:818-360-4200
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA5090237700000X
CA14884111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHA5090OtherHEARING AID DISPENSER
CADC14884AMedicare PIN