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General NPI Number Information
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NPI Number | 1124298856
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Entity Type | Organization
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Legal Business Name | RENUKA BOYAPALLI M D A MEDICAL CORPORATION
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Dates
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Enumeration Date | 03/10/2008
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Last Update Date | 11/17/2022
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Provider Practice Location Address
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Address Line | 3640 LOMITA BLVD STE 305
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City | TORRANCE
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State | CA
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Zip | 90505-3959
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Country | US
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Telephone | 310-373-0250
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Fax | 310-373-0256
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Provider Business Mailing Address
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Address Line | 3640 LOMITA BLVD STE 305
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City | TORRANCE
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State | CA
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Zip | 90505-3959
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Country | US
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Telephone | 310-373-0250
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Fax | 310-373-0256
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Authorized Official
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Title or Position | PRESIDENT
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Name | RENUKA R BOYAPALLI
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Credential | MD
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Telephone | 310-373-0250
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | A56036
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License Number State | CA
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