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General NPI Number Information
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NPI Number | 1508052341
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Entity Type | Organization
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Legal Business Name | EDUARDO O LIM MEDICAL CORPORATION
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Dates
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Enumeration Date | 09/14/2007
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Last Update Date | 11/19/2014
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Provider Practice Location Address
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Address Line | 201 S ALVARADO ST SUITE 505
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City | LOS ANGELES
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State | CA
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Zip | 90057-2320
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Country | US
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Telephone | 213-484-0146
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Fax | 213-483-3032
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Provider Business Mailing Address
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Address Line | PO BOX 26807
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City | LOS ANGELES
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State | CA
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Zip | 90026-0807
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Country | US
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Telephone | 213-484-0146
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Fax | 213-483-3032
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EDUARDO ONG LIM
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Credential | M.D.
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Telephone | 213-484-0146
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | A49674
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License Number State | CA
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