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NPI Code Detail

MEDICARE: FRED T LIM MD

MEDICARE: FRED T LIM MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology PhysicianA75403CA
22085R0204XVascular & Interventional Radiology PhysicianA75403CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1801859715
Entity Type Code : Individual
Provider Name (Legal Business Name) : FRED T LIM MD
Provider Business Mailing Address
First Line : 1801 W OLYMPIC BLVD # 2102
Second Line :
City : PASADENA
State : CA
Zip : 91199-0574
Country : US
Telephone Number : 661-249-6628
Fax Number :
Provider Business Practice Location Address
First Line : 1420 S CENTRAL AVE
Second Line :
City : GLENDALE
State : CA
Zip : 91204-2508
Country : US
Telephone Number : 818-502-2327
Fax Number : 626-795-4894
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2006
Last Update Date : 06/21/2025

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