Provider Demographics
NPI:1932660149
Name:BURLEY, NICHOLAS BOND (DO)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:BOND
Last Name:BURLEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27799 MEDICAL CENTER RD
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6400
Mailing Address - Country:US
Mailing Address - Phone:844-959-4673
Mailing Address - Fax:
Practice Address - Street 1:27799 MEDICAL CENTER RD
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6400
Practice Address - Country:US
Practice Address - Phone:844-959-4673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-29
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A20254207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology