Individual provider Active NPI

Anthony Robert Lim

  • Student in an Organized Health Care Education/Training Program
  • Los Angeles, CA
National Provider Identifier
1932859741
Registry record updated Mar 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
2051 Marengo St
Los Angeles, CA 90033-1352
Phone
(925) 786-2017
NPI assigned
Mar 25, 2022
Last updated
Mar 25, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary

Addresses

Primary practice location

2051 Marengo St
Los Angeles, CA 90033-1352

Mailing address

415 Shirlee Dr
Danville, CA 94526-1857

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
I20251112001634 CA Practitioner - General Surgery 5597139402 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Hawaii John a. Burns School of Medicine, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

393 E Walnut 3Rd FL
Pasedena, CA 91188-0001

393 E Walnut St FL
3 PHR Group Provider Enrollment Unit
Pasadena, CA 91188-0001

4200 Via Arbolada
Unit 221
Los Angeles, CA 90042-5072

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Oct 1, 2025 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Oct 1, 2025 Accepting new patients

Locations

6041 Cadillac Ave
Los Angeles, CA 90034
Phone (323) 857-2000

Organizations & group practices 3

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": "1648166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648166400000",
    "number": "1932859741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 SHIRLEE DR",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945261857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2051 MARENGO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331352",
            "telephone_number": "925-786-2017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIM",
        "first_name": "ANTHONY",
        "middle_name": "ROBERT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-25",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.