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General NPI Number Information
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NPI Number | 1699265850
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Entity Type | Organization
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Legal Business Name | LORI L VANYO MD FACS INC
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Dates
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Enumeration Date | 05/14/2018
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Last Update Date | 08/09/2024
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Provider Practice Location Address
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Address Line | 1910 ROYALTY DR
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City | POMONA
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State | CA
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Zip | 91767-3021
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Country | US
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Telephone | 909-766-1600
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Fax | 909-766-1601
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Provider Business Mailing Address
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Address Line | 1910 ROYALTY DR
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City | POMONA
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State | CA
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Zip | 91767-3021
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Country | US
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Telephone | 909-766-1600
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Fax | 909-766-1601
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Authorized Official
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Title or Position | PRESIDENT
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Name | LORI L VANYO
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Credential | MD
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Telephone | 909-766-1600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | BV4898447
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License Number State | CA
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