Active NPI
Myriam Boutary
- Family Nurse Practitioner
- Torrance, CA
National Provider Identifier
1891022778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 19222
- Practice address
- 4235 Pacific Coast Hwy
Torrance, CA 90505-5525 - Phone
- (866) 389-2727
- NPI assigned
- Nov 12, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 19222 | CA | Primary |
Addresses
Primary practice location
4235 Pacific Coast Hwy
Torrance, CA 90505-5525
Mailing address
19952 Felcliff LN
Huntington Beach, CA 92646-3925
Phone (714) 309-7766
Other practice location 1
19121 Beach Blvd
Huntington Beach, CA 92648-2307
Phone (714) 309-7766
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19222 | CA | MD | Physician Assistant |
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1257984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601856000000",
"number": "1891022778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19952 FELCLIFF LN",
"city": "HUNTINGTON BEACH",
"state": "CA",
"postal_code": "926463925",
"telephone_number": "714-309-7766"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4235 PACIFIC COAST HWY",
"city": "TORRANCE",
"state": "CA",
"postal_code": "905055525",
"telephone_number": "866-389-2727"
}
],
"practiceLocations": [
{
"address_1": "19121 Beach Blvd",
"address_purpose": "LOCATION",
"city": "Huntington Beach",
"state": "CA",
"postal_code": "926482307",
"country_code": "US",
"telephone_number": "714-309-7766",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BOUTARY",
"first_name": "MYRIAM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-11-12",
"last_updated": "2020-10-05",
"certification_date": "2020-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "19222",
"primary": true
}
],
"identifiers": [],
"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 Oct 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.