Individual provider Active NPI

Bernadette Anne Lim, D.O.

  • Family Medicine Physician
  • Glendale, CA
National Provider Identifier
1104933761
Registry record updated Sep 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A9107 Issued in CA
Practice address
1505 Wilson Ter
Suite 250
Glendale, CA 91206-4071
Phone
(818) 246-7115
Fax
(818) 246-8352
NPI assigned
Aug 23, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A9107 CA Primary

Addresses

Primary practice location

1505 Wilson Ter
Suite 250
Glendale, CA 91206-4071

Mailing address

1505 Wilson Ter
Suite 250
Glendale, CA 91206-4071
Phone (818) 246-7115

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121105000154 CA Practitioner - Family Practice 4981855731 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
9107CAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Affiliates Medical Group Family Medicine CurrentSince Sep 16, 2012 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Sep 16, 2012 Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

2699 Atlantic Ave
Long Beach, CA 90806
Phone (562) 426-2105

1025 W Olympic Blvd
Los Angeles, CA 90015
Phone (213) 623-2225

2601 Via Campo
Montebello, CA 90640
Phone (323) 720-1144

601 Torrance Blvd
#1182
Redondo Beach, CA 90277

3501 S Harbor Blvd
Santa Ana, CA 92704
Phone (714) 784-1658

14600 Sherman Way
Ste 300
Van Nuys, CA 91405
Phone (818) 208-7138

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379376000000",
    "number": "1104933761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 WILSON TER",
            "address_2": "SUITE 250",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064071",
            "telephone_number": "818-246-7115",
            "fax_number": "818-246-8352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 WILSON TER",
            "address_2": "SUITE 250",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064071",
            "telephone_number": "818-246-7115",
            "fax_number": "818-246-8352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIM",
        "first_name": "BERNADETTE",
        "middle_name": "ANNE",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-23",
        "last_updated": "2013-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A9107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.