Provider Demographics
NPI:1508430968
Name:LIM, ALEX (MD MPH)
Entity type:Individual
Prefix:
First Name:ALEX
Middle Name:
Last Name:LIM
Suffix:
Gender:
Credentials:MD MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 W LA PALMA AVE STE 404
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-2806
Mailing Address - Country:US
Mailing Address - Phone:520-694-8888
Mailing Address - Fax:
Practice Address - Street 1:1211 W LA PALMA AVE STE 404
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-2806
Practice Address - Country:US
Practice Address - Phone:520-694-8888
Practice Address - Fax:520-694-1640
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-19
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR78625207Q00000X
CA201333207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine