Central Pediatrics Medical Group

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A55951 Issued in CA

Legal business name

CENTRAL PEDIATRICS MEDICAL GROUP

Practice address

12598 Central Ave
Suite a
Chino, CA 91710

Phone

(909) 364-1234

Fax

(909) 364-1227

NPI assigned

Jul 7, 2006

Last updated

Feb 18, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Carolyne Tan Lim, M.D.NPI 1114942265

Title

Owner

Phone

(909) 364-1234

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Carolyne Tan Lim, M.D.

  • Pediatrics Physician
  • Chino, CA
  • NPI 1114942265
  NPD (past) Authorized official

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297987200000",
    "number": "1396777843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "529 W LE ROY AVE",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910077335",
            "telephone_number": "626-446-7858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12598 CENTRAL AVE",
            "address_2": "SUITE A",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "91710",
            "telephone_number": "909-364-1234",
            "fax_number": "909-364-1227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL PEDIATRICS MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2011-02-18",
        "status": "A",
        "authorized_official_last_name": "LIM",
        "authorized_official_first_name": "CAROLYNE",
        "authorized_official_middle_name": "TAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-364-1234",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A55951",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0079780",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Chino, CA
• Providers in Chino, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.