Provider Demographics
NPI:1477675734
Name:RENEE LIM NGO PC
Entity Type:Organization
Organization Name:RENEE LIM NGO PC
Other - Org Name:RENEE LIM NGO, MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:L
Authorized Official - Last Name:NGO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-855-0748
Mailing Address - Street 1:PO BOX 778207
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89077-8207
Mailing Address - Country:US
Mailing Address - Phone:702-855-0748
Mailing Address - Fax:
Practice Address - Street 1:3680 E SUNSET RD STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-7219
Practice Address - Country:US
Practice Address - Phone:702-855-0748
Practice Address - Fax:702-436-8088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-05
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV109052084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVTXIXMedicaid