Leo Gan-Lim, M.D., Prof Corp

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

LEO GAN-LIM, M.D., PROF CORP

Practice address

653 N Town Center Dr Ste 101
Las Vegas, NV 89144-0515

Phone

(702) 485-2791

Fax

(702) 485-2812

NPI assigned

Sep 23, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Leonardo Gan-LimNPI 1134180839

Title

Managing Member

Phone

(702) 461-2707

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Leonardo Aldecoa Gan-Lim, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Las Vegas, NV
  • NPI 1134180839
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1600819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692057600000",
    "number": "1093322158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2654 TOPAZ BLUE ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891465490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "653 N TOWN CENTER DR STE 101",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891440515",
            "telephone_number": "702-485-2791",
            "fax_number": "702-485-2812"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "657 N Town Center Dr",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891446367",
            "country_code": "US",
            "telephone_number": "702-453-3799",
            "fax_number": "702-453-5741",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LEO GAN-LIM, M.D., PROF CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-23",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A",
        "authorized_official_last_name": "GAN-LIM",
        "authorized_official_first_name": "LEONARDO",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "702-461-2707"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittni Marie Lents, IBCLC
• Douglas Munro Lentz, DPT
• Nasslynne Lenz, APRN, AGPCNP-BC
• Maria Elena Lenzano Arias
• Sierra Marie Lenzi
• Leo J. Capobianco, D.O., LTD.
• Leo Soo Hoo Ma Inc
• Leo Soo Hoo, M.a., Inc.
• Marielle Leo
• Nannina Leo

• Internal Medicine Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Internal Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.