Provider Demographics
NPI:1124205869
Name:CARMELO LIM ROCO, M.D.
Entity Type:Organization
Organization Name:CARMELO LIM ROCO, M.D.
Other - Org Name:CARMELO LIM ROCO,M.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INTERNAL MEDICINE
Authorized Official - Prefix:DR
Authorized Official - First Name:CARMELO
Authorized Official - Middle Name:LIM
Authorized Official - Last Name:ROCO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-421-2256
Mailing Address - Street 1:490 POST STREET
Mailing Address - Street 2:SUITE 901
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102
Mailing Address - Country:US
Mailing Address - Phone:415-421-2256
Mailing Address - Fax:415-421-9024
Practice Address - Street 1:490 POST STREET
Practice Address - Street 2:SUITE 901
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102
Practice Address - Country:US
Practice Address - Phone:415-421-2256
Practice Address - Fax:415-421-9024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-24
Last Update Date:2009-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A477701Medicaid
CANPI 1316996465OtherNPI
CA00A477700Medicare PIN
CAE71030Medicare UPIN