Individual provider Active NPI

Sokpheap Lim

  • Family Nurse Practitioner
  • Costa Mesa, CA
National Provider Identifier
1124611207
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95016646 Issued in CA
Practice address
150 Paularino Ave Ste 182
Costa Mesa, CA 92626-3301
Phone
(800) 482-5174
NPI assigned
Feb 18, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95016646 CA Primary

Addresses

Primary practice location

150 Paularino Ave Ste 182
Costa Mesa, CA 92626-3301

Mailing address

150 Paularino Ave Ste 182
Costa Mesa, CA 92626-3301

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210311001555 CA Practitioner - Nurse Practitioner 4082020383 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medical Wellness Centers USAGroup PAC ID 1759665367, 30 clinicians

Practice addresses (Care Compare)

1360 E Anaheim St
Suite 101
Long Beach, CA 90813-5514

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Wellness Centers USA CurrentSince Nov 7, 2024 Accepting new patients
Global Transitional Care, LLC CurrentSince Mar 4, 2021 Accepting new patients
Community Medical Wellness Centers USA CurrentSince Nov 7, 2024 Accepting new patients

Locations

5161 California Ave
Ste 200
Irvine, CA 92617
Phone (949) 543-0124

1360 E Anaheim St
Ste 101
Long Beach, CA 90813
Phone (562) 270-0324

Organizations & group practices 3

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": "1613606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1124611207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 PAULARINO AVE STE 182",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926263301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 PAULARINO AVE STE 182",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926263301",
            "telephone_number": "800-482-5174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIM",
        "first_name": "SOKPHEAP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-18",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95016646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

Verify at the official NPI Registry.