NPIMap

Individual provider Active NPI

Anthony Lim, PA-C

  • Physician Assistant
  • La Puente, CA
National Provider Identifier
1922477991
Registry record updated Sep 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
52841 Issued in CA
Practice address
923 Lidford Ave
La Puente, CA 91744-3225
Phone
(626) 827-8901
NPI assigned
Sep 21, 2015
Last updated
Sep 21, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 52841 CA Primary

Addresses

Primary practice location

923 Lidford Ave
La Puente, CA 91744-3225

Mailing address

923 Lidford Ave
La Puente, CA 91744-3225
Phone (626) 827-8901

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
I20151105002887 CA Practitioner - Physician Assistant 0840500609 Reassigns benefits to 7 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
52841CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Andy Shen, M.D., Inc. CurrentSince Nov 15, 2025 Accepting new patients
Gem Medical Group Corporation Past Accepting new patients

Locations

100 S Raymond Ave
Alhambra, CA 91801
Phone (626) 457-7938

Organizations & group practices 8

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": "1442793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442793600000",
    "number": "1922477991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "923 LIDFORD AVE",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917443225",
            "telephone_number": "626-827-8901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "923 LIDFORD AVE",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917443225",
            "telephone_number": "626-827-8901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIM",
        "first_name": "ANTHONY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-21",
        "last_updated": "2015-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "52841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Puente, CA

Sources for this page

Verify at the official NPI Registry.