Unknown Individual – Family Medicine Physician, NPI 1710986740
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,034 GENERAL PRACTICE in CA
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Provider Addresses for Unknown Individual
Lomita Boulevard, Torrance, Los Angeles County, California, 90717, United States
SUITE # 421
TORRANCE, CA 905053931
Phone: (310) 540-5464
Fax: (310) 540-4761
Type: Location
3655 LOMITA BLVD STE 421
TORRANCE, CA 905051934
Phone: (310) 540-5464
Fax: (310) 540-4761
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 25 Open Payments records for all available years, with a total value of $1,552.
Total Amount is formed as General ($1,552) + Research ($0) + Ownership ($0) = $1,552.
Last reported payment date: 2024-10-29 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($388).
Total Amount
$1,552
General + Research + Ownership
Payments
25
Total payment records
General Amount
$1,552
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-29
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| AstraZeneca Pharmaceuticals LP | $388 |
| Medtronic, Inc. | $253 |
| Merck Sharp & Dohme LLC | $250 |
| Bayer Healthcare Pharmaceuticals Inc. | $247 |
| Amgen Inc. | $165 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20110407000464 | I | General Practice | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 98 | 45 | $0 |
Insurance plans in this area (ZIP 90505)
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