Provider Demographics
NPI:1801120282
Name:LIMA, THOMAS ALLAN (OPA ATC)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:ALLAN
Last Name:LIMA
Suffix:
Gender:M
Credentials:OPA ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8929 UNIVERSITY CENTER LN STE 205
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92122-1008
Mailing Address - Country:US
Mailing Address - Phone:858-657-0000
Mailing Address - Fax:
Practice Address - Street 1:8929 UNIVERSITY CENTER LN STE 205
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92122-1008
Practice Address - Country:US
Practice Address - Phone:858-657-0000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-01
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1080172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker