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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

VICMAR BURGONIO FNP
NPI 1710604525
Nurse Practitioner - Family in Artesia, CA

Active since October 24, 2022
17100 PIONEER BLVD STE 420, ARTESIA, CA 90701(562) 246-8103 Get Directions Write a Review

NPPES record last updated: July 7, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 7, 2026, Jun 8, 2025, Oct 24, 2022 (3 updates tracked since 2022).

About Vicmar Burgonio Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VICMAR BURGONIO FNP (NPI 1710604525) is an individual family provider in Artesia, California, licensed in California (NP95022430) and active in the NPI registry since October 2022. He maintains a secondary practice location in Anaheim.

NPPES Registry Identity

NPI1710604525
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameVICMAR BURGONIOCredential: FNP
Location Address17100 PIONEER BLVD STE 420Artesia, CA 90701-2773
Mailing Address4330 E Miraloma AveAnaheim, CA 92807-1886
Phone(562) 246-8103
Sole ProprietorYes
Enumeration DateOctober 24, 2022
Last NPPES UpdateJuly 7, 20263 updates tracked since enumeration
NPPES CertifiedJuly 7, 2026
✔ NPI 1710604525 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in CA · NP95022430
Also ListedNurse Practitioner · Psychiatric/Mental HealthTaxonomy 363LP0808X · License NP95022430 (CA)
17100 PIONEER BLVD STE 420, Artesia, CA 90701
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Secondary Practice Location 1

Location 14330 E Miraloma AveAnaheim, CA 92807-1886 · Phone (800) 464-4000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Vicmar Burgonio's NPI number?

The NPI number for Vicmar Burgonio is 1710604525. It was assigned to this individual provider in the NPPES registry on October 24, 2022.

Where is Vicmar Burgonio located?

Vicmar Burgonio practices at 17100 Pioneer Blvd Ste 420, Artesia, CA 90701. The listed phone number is (562) 246-8103.

What is Vicmar Burgonio's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Vicmar Burgonio was last updated on July 7, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.