NPIMap

Organization Active NPI

Monte Carl Burnam Physician Assistant Professional Corporation

  • Medical Physician Assistant
  • Long Beach, CA
National Provider Identifier
1881903680
Registry record updated Sep 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA10764 Issued in CA
Legal business name
MONTE CARL BURNAM PHYSICIAN ASSISTANT PROFESSIONAL CORPORATION
Doing business as
Primary Care Skin Solutions By Physician Assistants and Medical Doctor
Practice address
1145 E Amelia Dr
Long Beach, CA 90807-2403
Phone
(323) 360-1864
NPI assigned
Sep 28, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Monte Carl Burnam, PANPI 1639129729
Title
President
Phone
(323) 360-1864

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AM0700X PA10764 CA Primary

Addresses

Primary practice location

1145 E Amelia Dr
Long Beach, CA 90807-2403

Mailing address

1145 E Amelia Dr
Long Beach, CA 90807-2403
Phone (323) 360-1864

Other names 1

  • Primary Care Skin Solutions By Physician Assistants and Medical Doctor Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1285632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285632000000",
    "number": "1881903680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 E AMELIA DR",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908072403",
            "telephone_number": "323-360-1864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 E AMELIA DR",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908072403",
            "telephone_number": "323-360-1864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTE CARL BURNAM PHYSICIAN ASSISTANT PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-28",
        "last_updated": "2010-09-28",
        "status": "A",
        "authorized_official_last_name": "BURNAM",
        "authorized_official_first_name": "MONTE",
        "authorized_official_middle_name": "CARL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-360-1864",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA10764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Primary Care Skin Solutions By Physician Assistants and Medical Doctor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.