Provider Demographics
NPI:1023572039
Name:LIM, HYO JOO (FNP-C)
Entity Type:Individual
Prefix:
First Name:HYO JOO
Middle Name:
Last Name:LIM
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3959 TROPICAL DR
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-3132
Mailing Address - Country:US
Mailing Address - Phone:213-278-3617
Mailing Address - Fax:
Practice Address - Street 1:266 S HARVARD BLVD STE 366
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90004-3987
Practice Address - Country:US
Practice Address - Phone:213-413-2622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-23
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95010915363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily