Physician Compare National (NPI:1194818765)

HEALTHCARE PROVIDER:

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1194818765
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9830253376
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20090129000075
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	LIM
	Individual professional last name
Provider First Name	DUCK
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1974
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	10700 BALBOA BLVD
	Group Practice or individual's line 1 address
City	GRANADA HILLS
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	913445001
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8183666550
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y