Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | G63561 | CA |
NPI | 1023050937 |
---|---|
Provider Name | David C Lim |
First Address | Stockton, CA 95204-6118 |
Second Address | Stockton, CA 95204-6118 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F57377 | (02) | CA |