1295756518 NPI number — TERESA ANH TRAN-LIM M.D.

Table of content: TERESA ANH TRAN-LIM M.D. (NPI 1295756518)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295756518 NPI number — TERESA ANH TRAN-LIM M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TRAN-LIM
Provider First Name:
TERESA
Provider Middle Name:
ANH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
TRAN
Provider Other First Name:
TERESA
Provider Other Middle Name:
AHN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1295756518
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/05/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3931 LOUISIANA AVE S
Provider Second Line Business Mailing Address:
SUITE E500
Provider Business Mailing Address City Name:
ST LOUIS PARK
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55426-4375
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
952-993-3200
Provider Business Mailing Address Fax Number:
952-993-2701

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6490 EXCELSIOR BLVD
Provider Second Line Business Practice Location Address:
SUITE E500
Provider Business Practice Location Address City Name:
ST LOUIS PARK
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55426-4705
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
952-993-3200
Provider Business Practice Location Address Fax Number:
952-993-2701
Provider Enumeration Date:
07/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084N0400X , with the licence number:  42462 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 05-81570 . This is a "MEDICA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 01014964 . This is a "PREFERRED ONE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 130021476 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: A016 . This is a "TRIWEST" identifier . This identifiers is of the category "OTHER".
  • Identifier: 47B98TR . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: HP37171 . This is a "HEALTHPARTNERS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 41-1677590 . This is a "WEA TRUST INSURANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 41-1677590 . This is a "1ST CHOICE OF THE MIDWEST" identifier . This identifiers is of the category "OTHER".
  • Identifier: 975338 . This is a "AMERICAS PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 088495200 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10088 , issued by the state of ( ND ) . This identifiers is of the category "MEDICAID".




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