Active NPI
Edward Burgos Nino, NP
- Psychiatric/Mental Health Nurse Practitioner
- Los Angeles, CA
National Provider Identifier
1053486944
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- NP14333
- Practice address
- 11080 W Olympic Blvd
Los Angeles, CA 90064-1937 - Phone
- (310) 913-4310
- NPI assigned
- Nov 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | NP #14333 | CA | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | NP14333 | CA | Primary |
Addresses
Primary practice location
11080 W Olympic Blvd
Los Angeles, CA 90064-1937
Mailing address
11080 W Olympic Blvd
Los Angeles, CA 90064-1937
Phone (310) 913-4310
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| WNP14333A | Other | CA | PPIN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NP #14333 | CA | MD | Family Nurse Practitioner |
| NP14333 | CA | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amha Medical Group, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Psychiatry Physician
- Torrance, CA
- NPI 1518030642
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741046400000",
"number": "1053486944",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11080 W OLYMPIC BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900641937",
"telephone_number": "310-913-4310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11080 W OLYMPIC BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900641937",
"telephone_number": "310-913-4310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NINO",
"first_name": "EDWARD",
"middle_name": "BURGOS",
"name_prefix": "Mr.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-24",
"last_updated": "2025-03-04",
"certification_date": "2025-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "NP #14333",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "CA",
"license": "NP14333",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PPIN",
"identifier": "WNP14333A",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.