Healthcare Provider Details

I. General information

NPI: 1821668757
Provider Name (Legal Business Name): RENATO JOSE YUPARI YUI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2021
Last Update Date: 07/17/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5757 HARPER DR NE
ALBUQUERQUE NM
87109-3566
US

IV. Provider business mailing address

8801 HORIZON BLVD NE STE 360
ALBUQUERQUE NM
87113-1563
US

V. Phone/Fax

Practice location:
  • Phone: 505-888-5757
  • Fax:
Mailing address:
  • Phone: 505-246-2622
  • Fax: 505-715-5334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD2024-1043
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: