Healthcare Provider Details

I. General information

NPI: 1497951693
Provider Name (Legal Business Name): DARRYL ERWIN WARREN RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 N VERMONT AVE 8TH FL. RM. 8300
LOS ANGELES CA
90027-5337
US

IV. Provider business mailing address

1515 N VERMONT AVE 8TH FL. RM. 8300
LOS ANGELES CA
90027-5337
US

V. Phone/Fax

Practice location:
  • Phone: 323-783-8987
  • Fax: 323-783-1276
Mailing address:
  • Phone: 323-783-8987
  • Fax: 323-783-1276

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number550359
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number550359
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License Number550359
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: