Healthcare Provider Details

I. General information

NPI: 1174727200
Provider Name (Legal Business Name): LILY SEIN LIM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2007
Last Update Date: 05/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13652 CANTARA ST
PANORAMA CITY CA
91402-5423
US

IV. Provider business mailing address

393 E WALNUT ST 3RD FLOOR PHR SYSTEMS
PASADENA CA
91188-0001
US

V. Phone/Fax

Practice location:
  • Phone: 818-375-2000
  • Fax: 818-375-2221
Mailing address:
  • Phone: 877-608-0044
  • Fax: 626-405-4600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA42284
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: