| Premiere Medical Center Of Burbank, Inc. | |
|
4418 Vineland Ave Ste 102 Toluca Lake CA 91602-3457 | |
| (818) 842-7145 | |
| (818) 842-8202 |
| Full Name | Premiere Medical Center Of Burbank, Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 4418 Vineland Ave Ste 102, Toluca Lake, California |
| Authorized Official Name and Position | Michael David Marsh (PHYSICIAN/OWNER) |
| Authorized Official Contact | 8188427145 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premiere Medical Center Of Burbank, Inc. 4418 Vineland Ave Ste 102 Toluca Lake CA 91602-3457 Ph: (818) 842-7145 | Premiere Medical Center Of Burbank, Inc. 4418 Vineland Ave Ste 102 Toluca Lake CA 91602-3457 Ph: (818) 842-7145 |
| NPI Number | 1831329218 |
|---|---|
| Provider Enumeration Date | 07/20/2009 |
| Last Update Date | 10/26/2018 |
| Medicare PECOS PAC ID | 4688709744 |
|---|---|
| Medicare Enrollment ID | O20100316000142 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831329218 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 213E00000X | Podiatrist | E4419 (California) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Stuart L Shear |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1053345009 PECOS PAC ID: 0547161267 Enrollment ID: I20040115001188 |
| Provider Name | Bruce M Stark |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902801301 PECOS PAC ID: 4183514854 Enrollment ID: I20040317000318 |
| Provider Name | Jon P Kea |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1952551228 PECOS PAC ID: 0648320184 Enrollment ID: I20090604000209 |
| Provider Name | Michael D Marsh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619992047 PECOS PAC ID: 5991606618 Enrollment ID: I20100308000447 |
| Provider Name | Geoffrey K Lloyd |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821104845 PECOS PAC ID: 7810029279 Enrollment ID: I20100720000886 |
| Provider Name | Jose Luis Hernandez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912202938 PECOS PAC ID: 3678726221 Enrollment ID: I20130109000503 |
| Provider Name | Victoria Chan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831590322 PECOS PAC ID: 2264756352 Enrollment ID: I20150120002071 |
| Provider Name | Samantha Marie Alburn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770974339 PECOS PAC ID: 6406168483 Enrollment ID: I20150706000329 |
| Provider Name | Debra Lesin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952701500 PECOS PAC ID: 1557660685 Enrollment ID: I20160425000982 |
| Provider Name | Stewart Borden Reed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548680143 PECOS PAC ID: 0446520621 Enrollment ID: I20170720001549 |
| Provider Name | Angela Altman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831612589 PECOS PAC ID: 9335223353 Enrollment ID: I20180213001466 |
| Provider Name | Lauren Ashley Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679012777 PECOS PAC ID: 3577826718 Enrollment ID: I20180420002095 |
| Provider Name | Angelica Menchaca |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831654573 PECOS PAC ID: 2961834288 Enrollment ID: I20191107000553 |
| Provider Name | Dovber Hecht |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497311468 PECOS PAC ID: 0244624740 Enrollment ID: I20220228000216 |
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