Dr. Derrick G. Lim

Primary specialty

OptometristTaxonomy code 152W00000X

License

10509T Issued in CA

Legal business name

DR. DERRICK G. LIM

Practice address

5657 Atlantic Ave
Long Beach, CA 90805-4710

Phone

(562) 422-3378

NPI assigned

Jul 8, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Derrick Guy Lim

Title

Owner

Phone

(562) 422-3378

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237248000000",
    "number": "1700819505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5657 ATLANTIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908054710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5657 ATLANTIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908054710",
            "telephone_number": "562-422-3378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. DERRICK G. LIM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2009-03-17",
        "status": "A",
        "authorized_official_last_name": "LIM",
        "authorized_official_first_name": "DERRICK",
        "authorized_official_middle_name": "GUY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "562-422-3378",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10509T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0105091",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2009; 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.