Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 38554 | CA |
Y | 213EG0000X | General Practice | 38554 | CA |
NPI | 1003039298 |
---|---|
Provider Name | Dr. Bella Tallo Lim |
First Address | Daly City, CA 94014-2922 |
Second Address | Daly City, CA 94014-2922 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2007 |
Last Update Date | 08/07/2007 |