Healthcare Provider Details

I. General information

NPI: 1982760500
Provider Name (Legal Business Name): ERL MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 08/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 WILSHIRE BLVD STE 1510
LOS ANGELES CA
90048-5801
US

IV. Provider business mailing address

6200 WILSHIRE BLVD STE 1510
LOS ANGELES CA
90048-5801
US

V. Phone/Fax

Practice location:
  • Phone: 323-964-1440
  • Fax: 323-937-5283
Mailing address:
  • Phone: 323-964-1440
  • Fax: 323-937-5283

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1262270001
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberA43525
License Number StateCA

VIII. Authorized Official

Name: DR. EMMANUEL R LIM
Title or Position: PRESIDENT/ MEDICAL DIRECTOR
Credential: MD
Phone: 323-964-1440