Provider Demographics
NPI:1891871018
Name:JOHN C LIM MD & FRANCINE F ITO MD A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:JOHN C LIM MD & FRANCINE F ITO MD A PROFESSIONAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CHIN-TIONG
Authorized Official - Last Name:LIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-540-5599
Mailing Address - Street 1:4201 TORRANCE BLVD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-4504
Mailing Address - Country:US
Mailing Address - Phone:310-792-3914
Mailing Address - Fax:310-792-3621
Practice Address - Street 1:4201 TORRANCE BLVD
Practice Address - Street 2:SUITE 310
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-4504
Practice Address - Country:US
Practice Address - Phone:310-792-3914
Practice Address - Fax:310-792-3621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG52785207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF15184Medicare UPIN
CAW9241AMedicare PIN
CAG63053Medicare UPIN
CAG52785Medicare PIN