Provider Demographics
NPI:1285824920
Name:WELMAN T. LIM, D.P.M., INC.
Entity Type:Organization
Organization Name:WELMAN T. LIM, D.P.M., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WELMAN
Authorized Official - Middle Name:T
Authorized Official - Last Name:LIM
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:626-792-4432
Mailing Address - Street 1:131 N EL MOLINO AVE
Mailing Address - Street 2:#230
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-1873
Mailing Address - Country:US
Mailing Address - Phone:626-792-4432
Mailing Address - Fax:626-792-0301
Practice Address - Street 1:131 N EL MOLINO AVE
Practice Address - Street 2:#230
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-1873
Practice Address - Country:US
Practice Address - Phone:626-792-4432
Practice Address - Fax:626-792-0301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-30
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE2785213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E27850Medicaid
CAE2785Medicare PIN
CA1085950001Medicare NSC
CAT19235Medicare UPIN