Tyrone C. Bordenave, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G376440 Issued in CA

Practice address

644 E Regent St
Suite 200
Inglewood, CA 90301-1433

Phone

(310) 674-5353

Fax

(310) 674-7041

NPI assigned

Aug 31, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265543292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "644 E REGENT ST",
            "address_2": "SUITE 200",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903011433",
            "telephone_number": "310-674-5353",
            "fax_number": "310-674-7041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "644 E REGENT ST",
            "address_2": "SUITE 200",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903011433",
            "telephone_number": "310-674-5353",
            "fax_number": "310-674-7041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORDENAVE",
        "first_name": "TYRONE",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G376440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bhavya Bommadi
• Claire Amber Bongiovanni, MA
• Gaby M. Bonilla
• Marva L Bood
• Nicole Borda
• Murdis Latoya Boston, MA
• Natasha Kimberly Bove, PA-C
• Philip Bowlay-Williams
• Michele Norene Boyer, RCP
• Vanessa Leshana Boykin, LVN

• Internal Medicine Physician in Inglewood, CA
• Providers in Inglewood, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.