Individual provider · NPI-1

Michael Lee Burris, FNP

Nurse Practitioner, Family · Mission Viejo, CA

NPI number1679012041
StatusActive
Last updated in NPPESMar 29, 2021

Details

NPI
1679012041
Entity type
Individual (NPI-1)
Name
Michael Lee Burris
Credential
FNP
Sex
Male
Sole proprietor
No
Enumeration date
Feb 18, 2017
Certification date
Mar 29, 2021
Last updated
Mar 29, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, Family95006035CAYes

Practice location

26991 Crown Valley Pkwy Ste 100
Mission Viejo, CA 92691-6528

Phone 949-582-5430 · Fax 949-348-9513

Mailing address

11 Mareblu Ste 210
Aliso Viejo, CA 92656-3044

Phone 949-831-1001

Other practice locations

11 Mareblu Ste 210
Aliso Viejo, CA 92656

Phone 949-831-1001

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