NPIMap

Organization Active NPI

Gettysburg Medical Clinic Inc

  • General Practice Physician
  • Fresno, CA
National Provider Identifier
1609112499
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
GETTYSBURG MEDICAL CLINIC INC
Practice address
5088 N Fresno St Ste D
Fresno, CA 93710-7611
Phone
(559) 222-9362
Fax
(559) 222-9369
NPI assigned
Dec 24, 2012
Organization subpart
Yes
Parent organization
GETTYSBURG MEDICAL CLINIC,INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Grace Wee Lim, MDNPI 1437256211
Title
President
Phone
(559) 244-6360

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207K00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

5088 N Fresno St Ste D
Fresno, CA 93710-7611

Mailing address

5088 N Fresno St Ste D
Fresno, CA 93710-7611
Phone (559) 222-9362

Other names 1

  • GETTYSBURG MEDICAL CLINIC,INC. Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0945142Gettysburg Medical Clinic Inc5088 N Fresno St Ste B, Fresno, CA 93710Certificate of waiverApr 26, 2028

National Provider Directory

National Provider Directory
Tax ID family
Gettysburg Medical Clinic8 organizations share this tax ID, including this one
Part of
Gettysburg Medical Clinic

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5088 N Fresno St
#B
Fresno, CA 93710

5088 N Fresno St
Ste D
Fresno, CA 93710
Phone (559) 222-9362

143 W Main St
Merced, CA 95340
Phone (209) 725-2060

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1356307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1609112499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5088 N FRESNO ST STE D",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937107611",
            "telephone_number": "559-222-9362",
            "fax_number": "559-222-9369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5088 N FRESNO ST STE D",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937107611",
            "telephone_number": "559-222-9362",
            "fax_number": "559-222-9369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GETTYSBURG MEDICAL CLINIC INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GETTYSBURG MEDICAL CLINIC,INC.",
        "enumeration_date": "2012-12-24",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "LIM",
        "authorized_official_first_name": "GRACE",
        "authorized_official_middle_name": "WEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "559-244-6360",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GETTYSBURG MEDICAL CLINIC,INC.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.