Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | G49660 | CA |
NPI | 1245234863 |
---|---|
Provider Name | Dr. Aileen D. Lim |
First Address | Tracy, CA 95376 |
Second Address | Redwood City, CA 94062-2751 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2005 |
Last Update Date | 11/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F28572 | (02) | |
F28572 | (02) | CA |