Provider Demographics
NPI:1568715324
Name:LIM, HENGKY (NP)
Entity Type:Individual
Prefix:DR
First Name:HENGKY
Middle Name:
Last Name:LIM
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37255 KINGCUP TER
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-6231
Mailing Address - Country:US
Mailing Address - Phone:818-967-0800
Mailing Address - Fax:
Practice Address - Street 1:37255 KINGCUP TER
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-6231
Practice Address - Country:US
Practice Address - Phone:818-967-0800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-18
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22416363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner