Individual provider Active NPI

Nicolas Limthong, M.D.

  • General Practice Physician
  • Ventura, CA
National Provider Identifier
1750726758
Registry record updated Aug 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A132915 Issued in CA
Practice address
148 N Brent St Ste 101
Ventura, CA 93003-2818
Phone
(805) 722-2468
Fax
(848) 260-2833
NPI assigned
May 3, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X A132915 CA Primary

Addresses

Primary practice location

148 N Brent St Ste 101
Ventura, CA 93003-2818

Mailing address

148 N Brent St Ste 101
Ventura, CA 93003-2818
Phone (805) 722-2468

Other practice location 1

11629 Clark St Ste 101
Arcadia, CA 91006-6022
Phone (626) 471-1326

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160108000559 CA Order and Referring Only - General PracticePractitioner - General Practice 4688976517

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
132915CAMDMarriage & Family Therapist
A132915CAMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1367539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1750726758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 N BRENT ST STE 101",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930032818",
            "telephone_number": "805-722-2468",
            "fax_number": "848-260-2833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 N BRENT ST STE 101",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930032818",
            "telephone_number": "805-722-2468",
            "fax_number": "848-260-2833"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11629 Clark St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Arcadia",
            "state": "CA",
            "postal_code": "910066022",
            "country_code": "US",
            "telephone_number": "626-471-1326",
            "fax_number": "626-872-6722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIMTHONG",
        "first_name": "NICOLAS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-03",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A132915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.