Provider Demographics
NPI:1669937215
Name:LIM, TONI ANH TU (PT, DPT)
Entity type:Individual
Prefix:MRS
First Name:TONI
Middle Name:ANH TU
Last Name:LIM
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11932 COURTLEIGH DR APT 2
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-7231
Mailing Address - Country:US
Mailing Address - Phone:424-645-8631
Mailing Address - Fax:
Practice Address - Street 1:6033 W CENTURY BLVD STE 200
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-6440
Practice Address - Country:US
Practice Address - Phone:310-215-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-08
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA296263225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist