Healthcare Provider Details

I. General information

NPI: 1821268814
Provider Name (Legal Business Name): JOHN C. LIM, MD AND FRANCINE ITO,MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2008
Last Update Date: 03/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 TORRANCE BLVD 310
TORRANCE CA
90503-4504
US

IV. Provider business mailing address

4201 TORRANCE BLVD 310
TORRANCE CA
90503-4504
US

V. Phone/Fax

Practice location:
  • Phone: 310-540-5599
  • Fax: 310-543-1549
Mailing address:
  • Phone: 310-540-5599
  • Fax: 310-543-1549

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: FRANCINE ITO
Title or Position: PRESIDENT
Credential: MD
Phone: 310-540-5599