Provider Demographics
NPI:1194148882
Name:LIM, VINCENT PHUOC (PA-C)
Entity type:Individual
Prefix:MR
First Name:VINCENT
Middle Name:PHUOC
Last Name:LIM
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:401 E CARRILLO ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-1460
Mailing Address - Country:US
Mailing Address - Phone:805-563-3307
Mailing Address - Fax:805-563-0998
Practice Address - Street 1:6326 VESPER AVE
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91411-2339
Practice Address - Country:US
Practice Address - Phone:818-779-1500
Practice Address - Fax:818-779-1551
Is Sole Proprietor?:No
Enumeration Date:2014-01-30
Last Update Date:2014-01-30
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant