Organization
CENTRAL PEDIATRICS MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAROLYNE TAN LIM M.D. (OWNER)
(909) 364-1234
Entity
Organization
Contact information
Practice address
12598 CENTRAL AVE, SUITE A, CHINO, CA 91710
(909) 364-1234
(909) 364-1227
Mailing address
529 W LE ROY AVE, ARCADIA, CA 91007-7335
(626) 446-7858
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A55951
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0079780
—
CA
Enumeration date
07/07/2006
Last updated
02/18/2011
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