Organization Active NPI

Renuka Boyapalli M D a Medical Corporation

  • Endocrinology, Diabetes & Metabolism Physician
  • Torrance, CA
National Provider Identifier
1124298856
Registry record updated Nov 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
A56036 Issued in CA
Legal business name
RENUKA BOYAPALLI M D A MEDICAL CORPORATION
Practice address
3640 Lomita Blvd Ste 305
Torrance, CA 90505-3959
Phone
(310) 373-0250
Fax
(310) 373-0256
NPI assigned
Mar 10, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2022

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

Authorized official

Name
Renuka R Boyapalli, MDNPI 1558399311
Title
President
Phone
(310) 373-0250

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RE0101X A56036 CA Primary

Addresses

Primary practice location

3640 Lomita Blvd Ste 305
Torrance, CA 90505-3959

Mailing address

3640 Lomita Blvd Ste 305
Torrance, CA 90505-3959
Phone (310) 373-0250

Other identifiers 1

IdentifierTypeStateIssuer
00A560360MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080404000421 CA Part B Supplier - Clinic/Group Practice 3072690759 Receives reassigned benefits from 2 practitioners
Practice locations: Torrance, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1205107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668643200000",
    "number": "1124298856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3640 LOMITA BLVD STE 305",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905053959",
            "telephone_number": "310-373-0250",
            "fax_number": "310-373-0256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3640 LOMITA BLVD STE 305",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905053959",
            "telephone_number": "310-373-0250",
            "fax_number": "310-373-0256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENUKA BOYAPALLI M D A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-10",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A",
        "authorized_official_last_name": "BOYAPALLI",
        "authorized_official_first_name": "RENUKA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-373-0250",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "A56036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A560360",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.