Marian J Wymore, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G50846 Issued in CA

Practice address

27336 Sunnyridge Rd
Palos Verdes Peninsula, CA 90274-4037

Phone

(310) 780-0155

Fax

(310) 377-8874

NPI assigned

Jul 23, 2011

Last updated

Jul 23, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1311379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311379200000",
    "number": "1902184062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27336 SUNNYRIDGE RD",
            "city": "PALOS VERDES PENINSULA",
            "state": "CA",
            "postal_code": "902744037",
            "telephone_number": "310-780-0155",
            "fax_number": "310-377-8874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27336 SUNNYRIDGE RD",
            "city": "PALOS VERDES PENINSULA",
            "state": "CA",
            "postal_code": "902744037",
            "telephone_number": "310-780-0155",
            "fax_number": "310-377-8874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYMORE",
        "first_name": "MARIAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-23",
        "last_updated": "2011-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G50846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Palos Verdes Peninsula, CA
• Providers in Palos Verdes Peninsula, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.