Provider Demographics
NPI:1073582250
Name:LIMJOCO, URIEL (MD)
Entity Type:Individual
Prefix:
First Name:URIEL
Middle Name:
Last Name:LIMJOCO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2238
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93232-2238
Mailing Address - Country:US
Mailing Address - Phone:559-587-0330
Mailing Address - Fax:559-587-0332
Practice Address - Street 1:804 W 7TH ST
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-4926
Practice Address - Country:US
Practice Address - Phone:559-587-0330
Practice Address - Fax:559-587-0332
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC38241208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C382410Medicaid
B54590Medicare UPIN
CA00C382410Medicaid