Healthcare Provider Details

I. General information

NPI: 1336971407
Provider Name (Legal Business Name): PHILIP YIM CRT, ARRT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2024
Last Update Date: 08/16/2024
Certification Date: 08/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3330 LOMITA BLVD
TORRANCE CA
90505-5002
US

IV. Provider business mailing address

3531 W 185TH ST
TORRANCE CA
90504-4918
US

V. Phone/Fax

Practice location:
  • Phone: 310-517-4675
  • Fax:
Mailing address:
  • Phone: 310-408-5646
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2471C3402X
TaxonomyRadiography Radiologic Technologist
License NumberRHF40766
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2471V0106X
TaxonomyVascular-Interventional Technology Radiologic Technologist
License NumberRHF40766
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: