Provider Demographics
NPI:1760439780
Name:LIM YAO, ALFREDO (MD)
Entity Type:Individual
Prefix:DR
First Name:ALFREDO
Middle Name:
Last Name:LIM YAO
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 1:6497 JAMES FRANCIS PL
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:IA
Mailing Address - Zip Code:50131-1928
Mailing Address - Country:US
Mailing Address - Phone:515-270-1842
Mailing Address - Fax:
Practice Address - Street 1:3600 30TH ST
Practice Address - Street 2:VACIHCS
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50310-5774
Practice Address - Country:US
Practice Address - Phone:515-699-5816
Practice Address - Fax:515-699-5909
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA222592085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology