Healthcare Provider Details

I. General information

NPI: 1245793355
Provider Name (Legal Business Name): ELIZABETH TONYAN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2019
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3075 VANDERCAR WAY
CINCINNATI OH
45209-7542
US

IV. Provider business mailing address

12900 PARK PLAZA DR STE 150
CERRITOS CA
90703-9329
US

V. Phone/Fax

Practice location:
  • Phone: 657-309-1619
  • Fax: 805-406-7157
Mailing address:
  • Phone: 657-309-1619
  • Fax: 805-406-7157

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number024981
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: