Healthcare Provider Details

I. General information

NPI: 1275716144
Provider Name (Legal Business Name): PETER C LIM MD LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2007
Last Update Date: 06/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 PRINGLE WAY LOWR LEVEL
RENO NV
89502-1464
US

IV. Provider business mailing address

PO BOX 11367
RENO NV
89510-1367
US

V. Phone/Fax

Practice location:
  • Phone: 775-327-4673
  • Fax: 775-327-4611
Mailing address:
  • Phone: 775-323-7717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: PETER C LIM
Title or Position: OWNER
Credential: MD
Phone: 775-323-7717