Provider Demographics
NPI:1902889264
Name:NGO, RENEE LIM (MD)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:LIM
Last Name:NGO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 778207
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89077-8207
Mailing Address - Country:US
Mailing Address - Phone:702-855-0748
Mailing Address - Fax:702-436-8088
Practice Address - Street 1:3680 E SUNSET RD STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-7219
Practice Address - Country:US
Practice Address - Phone:702-855-0748
Practice Address - Fax:702-436-8088
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV109052084P0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
432058646OtherPBH
432058646OtherTRICARE
NV100503733Medicaid
NVCS12498OtherCS
332338OtherMHN
432058646OtherUBH
1619902OtherCIGNA
432058646OtherMEDIVERSAL
NV1580OtherBCBS
21250983138OtherBEECHSTREET
727662000OtherMAGELLAN
2202522OtherCBH
432058646OtherTEACHERS HEALTH
432058646OtherPACIFICARE
9374117OtherPHCS
NV1580OtherHBI
NV1580OtherHBI
NVBN7827655OtherDEA
21250983138OtherBEECHSTREET
2202522OtherCBH