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General NPI Number Information
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NPI Number | 1154933034
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Entity Type | Individual
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Provider Name | ANDREW SEUNG-MIN LIM MD, BSC
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Gender | Male
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Dates
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Enumeration Date | 08/20/2020
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Last Update Date | 10/12/2022
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Provider Practice Location Address
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Address Line | 1441 EASTLAKE AVE
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City | LOS ANGELES
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State | CA
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Zip | 90089-1019
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Country | US
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Telephone | 323-865-3050
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 31309
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City | LOS ANGELES
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State | CA
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Zip | 90031-0309
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Country | US
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Telephone | 626-457-6601
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | MD61171770
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | A169906
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License Number State | CA
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