MEDICARE: DR. ALICE LIM YAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	A50244	CA

General Provider Information

NPI Number	:	1245265362
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALICE LIM YAN M.D.

Provider Business Mailing Address
First Line	:	1500 SOUTHGATE AVE STE 115
Second Line	:
City	:	DALY CITY
State	:	CA
Zip	:	94015-2205
Country	:	US
Telephone Number	:	650-991-4466
Fax Number	:	650-991-4467

Provider Business Practice Location Address
First Line	:	1500 SOUTHGATE AVE STE 115
Second Line	:
City	:	DALY CITY
State	:	CA
Zip	:	94015-2205
Country	:	US
Telephone Number	:	650-991-4466
Fax Number	:	650-991-4467

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	07/21/2022

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