Kenneth Tan Lim

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

28865 Issued in CA

Practice address

10442 Gaynor Ave
Granada Hills, CA 91344-7024

Phone

(818) 913-8820

NPI assigned

Oct 26, 2018

Last updated

Oct 26, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1540512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540512000000",
    "number": "1205303310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10442 GAYNOR AVE",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913447024",
            "telephone_number": "818-913-8820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10442 GAYNOR AVE",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913447024",
            "telephone_number": "818-913-8820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIM",
        "first_name": "KENNETH",
        "middle_name": "TAN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-26",
        "last_updated": "2018-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "28865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debbie Li
• Lifeline Dialysis Center LLC
• Lifelong Senior Living
• Jacob Lilley, DC
• Jungjae Lim, M.D.
• Lims Valley Medical Center Corporation
• Henry Yuheng Lin
• Wallace J Lipp, DDS
• Jennifer Van Liptawat, LAC
• Andrea Lira, M.S.

• Physical Therapist in Granada Hills, CA
• Providers in Granada Hills, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.