Provider Demographics
NPI:1063044337
Name:BURTON, KIRSTEEN RENNIE (MD)
Entity type:Individual
Prefix:DR
First Name:KIRSTEEN
Middle Name:RENNIE
Last Name:BURTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 ST. CLAIR AVENUE WEST, SUITE 1605
Mailing Address - Street 2:
Mailing Address - City:TORONTO
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:M4V1N5
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:UCSF DEPT. OF RADIOLOGY & BIOMEDICAL IMAGING
Practice Address - Street 2:513 PARNASSUS AVENUE
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:90103-0028
Practice Address - Country:US
Practice Address - Phone:415-476-1575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-05
Last Update Date:2021-02-23
Deactivation Date:2020-12-08
Deactivation Code:
Reactivation Date:2021-02-23
Provider Licenses
StateLicense IDTaxonomies
ZZ137416390200000X
CAA158430390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program