1477849982 NPI number — ELIZA LIM CAMBAY FNP-BC

Table of content: ELIZA LIM CAMBAY FNP-BC (NPI 1477849982)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477849982 NPI number — ELIZA LIM CAMBAY FNP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CAMBAY
Provider First Name:
ELIZA
Provider Middle Name:
LIM
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
FNP-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477849982
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/23/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
23451 MADISON ST
Provider Second Line Business Mailing Address:
SUITE 290
Provider Business Mailing Address City Name:
TORRANCE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90505-4763
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-375-1246
Provider Business Mailing Address Fax Number:
310-802-6077

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
23451 MADISON ST
Provider Second Line Business Practice Location Address:
SUITE 290
Provider Business Practice Location Address City Name:
TORRANCE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90505-4763
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-375-1246
Provider Business Practice Location Address Fax Number:
310-802-6077
Provider Enumeration Date:
06/22/2011

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: 363LF0000X , with the licence number:  20386 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 20386 . This is a "BOARD OF REGISTERED NURSING--NURSE PRACTITIONER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 75281 . This is a "BOARD OF REGISTERED NURSING--PUBLIC HEALTH NURSE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 687910 . This is a "BOARD OF REGISTERED NURSING--REGISTERED NURSE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 2010013955 . This is a "FNP-BC" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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