MEDICARE: ALBERT WHASIK LIM DDS

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	1223G0001X	General Practice Dentistry	23070	CA

General Provider Information

NPI Number	:	1720144082
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALBERT WHASIK LIM DDS

Provider Business Mailing Address
First Line	:	1211 N VERMONT AVE
Second Line	:	SUITE 102
City	:	LOS ANGELES
State	:	CA
Zip	:	90029-1748
Country	:	US
Telephone Number	:	323-666-7562
Fax Number	:	323-666-7564

Provider Business Practice Location Address
First Line	:	1211 N VERMONT AVE
Second Line	:	SUITE 102
City	:	LOS ANGELES
State	:	CA
Zip	:	90029-1748
Country	:	US
Telephone Number	:	323-666-7562
Fax Number	:	323-666-7564

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

Provider Enumeration Date	:	12/29/2006
Last Update Date	:	10/29/2008

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