NPIMap

Individual provider Active NPI

Dee Beng Ko Lim, M.D.

  • Family Medicine Physician
  • Montclair, CA
National Provider Identifier
1801805163
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C39980 Issued in CA
Practice address
9675 Monte Vista Ave
Suite B
Montclair, CA 91763-2233
Phone
(909) 447-5554
Fax
(909) 447-5582
NPI assigned
Aug 5, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X C39980 CA Primary

Addresses

Primary practice location

9675 Monte Vista Ave
Suite B
Montclair, CA 91763-2233

Mailing address

9675 Monte Vista Ave
Suite B
Montclair, CA 91763-2233
Phone (909) 447-5554

Other identifiers 1

IdentifierTypeStateIssuer
00C399801MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120112000529 CA Practitioner - Family Practice 7214938620 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1968
Medicare assignment
May accept Medicare assignment
Group practices
Pros Medical Clinic IncGroup PAC ID 2163687716, 2 clinicians

Practice addresses (Care Compare)

4959 Palo Verde St
Suite 101a
Montclair, CA 91763-2340
Phone (909) 621-2562

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C39980CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pros Medical Clinic, Inc. CurrentSince Jul 18, 2024 Accepting new patients
THC - Orange County, LLC Past Accepting new patients
Emanuel Medical Center, Inc. Past Accepting new patients
Cardiology Specialists Medical Group, Inc. Past Accepting new patients
Indus Healthcare, Inc. Family Medicine Past Accepting new patients
Pomona Valley Hospital Medical Center Past Accepting new patients
San Antonio Regional Hospital Past Accepting new patients
Doctors Hospital of Manteca, Inc. Past Accepting new patients

Locations

4959 Palo Verde St
Ste 101A
Montclair, CA 91763
Phone (909) 621-2562

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23222/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Priority One Home Health Services IncMontclair, CA, CCN 058063 Home health agency Corporate Director Jan 1, 2007

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801805163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9675 MONTE VISTA AVE",
            "address_2": "SUITE B",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917632233",
            "telephone_number": "909-447-5554",
            "fax_number": "909-447-5582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9675 MONTE VISTA AVE",
            "address_2": "SUITE B",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917632233",
            "telephone_number": "909-447-5554",
            "fax_number": "909-447-5582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIM",
        "first_name": "DEE BENG",
        "middle_name": "KO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C39980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C399801",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, CA

Sources for this page

Verify at the official NPI Registry.