Healthcare Provider Details
I. General information
NPI: 1891871018
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: 10/31/2006
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
4201 TORRANCE BLVD SUITE 310
TORRANCE CA
90503-4504
US
V. Phone/Fax
- Phone: 310-792-3914
- Fax: 310-792-3621
- Phone: 310-792-3914
- Fax: 310-792-3621
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VX0000X |
| Taxonomy | Obstetrics Physician |
| License Number | G52785 |
| License Number State | CA |
VIII. Authorized Official
Name:
JOHN
CHIN-TIONG
LIM
Title or Position: PRESIDENT
Credential:
Phone: 310-540-5599