Healthcare Provider Details
I. General information
NPI: 1962962753
Provider Name (Legal Business Name): ERYN WANYONYI MD, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/20/2019
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
444 S SAN VICENTE BLVD STE 1001
LOS ANGELES CA
90048-4170
US
IV. Provider business mailing address
4140 W 190TH ST
TORRANCE CA
90504-5513
US
V. Phone/Fax
- Phone: 310-423-3492
- Fax: 310-423-0140
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | A204665 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207VC0300X |
| Taxonomy | Complex Family Planning Physician |
| License Number | 036165429 |
| License Number State | IL |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 036165429 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: