Healthcare Provider Details

I. General information

NPI: 1316030158
Provider Name (Legal Business Name): JOHN C LIM MD & FRANCINE F ITO MD A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 02/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 TORRANCE BLVD SUITE 310
TORRANCE CA
90503-4504
US

IV. Provider business mailing address

PO BOX 3098
TORRANCE CA
90510-3098
US

V. Phone/Fax

Practice location:
  • Phone: 310-540-5599
  • Fax:
Mailing address:
  • Phone: 310-540-5599
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberG63053
License Number StateCA

VIII. Authorized Official

Name: JOHN CHIN-TIONG LIM
Title or Position: PRESIDENT
Credential: MD
Phone: 310-540-5599