Healthcare Provider Details

I. General information

NPI: 1477849982
Provider Name (Legal Business Name): ELIZA LIM CAMBAY FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2011
Last Update Date: 06/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23451 MADISON ST SUITE 290
TORRANCE CA
90505-4763
US

IV. Provider business mailing address

23451 MADISON ST SUITE 290
TORRANCE CA
90505-4763
US

V. Phone/Fax

Practice location:
  • Phone: 310-375-1246
  • Fax: 310-802-6077
Mailing address:
  • Phone: 310-375-1246
  • Fax: 310-802-6077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number20386
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: