Healthcare Provider Details

I. General information

NPI: 1225666464
Provider Name (Legal Business Name): COYIN OH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2020
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 S SAN VICENTE BLVD FL 7
LOS ANGELES CA
90048-3311
US

IV. Provider business mailing address

4140 W 190TH ST
TORRANCE CA
90504-5513
US

V. Phone/Fax

Practice location:
  • Phone: 310-423-8030
  • Fax: 310-967-8486
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberA208067
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: