Healthcare Provider Details

I. General information

NPI: 1982947131
Provider Name (Legal Business Name): PEI LIM BRIAN LEE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: PEI LIM BRIAN LEE

II. Dates (important events)

Enumeration Date: 04/05/2013
Last Update Date: 11/27/2023
Certification Date: 09/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 SAN PABLO ST STE 1000
LOS ANGELES CA
90033-5312
US

IV. Provider business mailing address

PO BOX 31309
LOS ANGELES CA
90031-0309
US

V. Phone/Fax

Practice location:
  • Phone: 323-442-5100
  • Fax:
Mailing address:
  • Phone: 323-442-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2966
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207RT0003X
TaxonomyTransplant Hepatology Physician
License NumberA142953
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberA142953
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: