Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0201X | Pediatric Allergist | A34863 | CA |
Y | 208D00000X | General Practice Physician | A34863 | CA |
NPI | 1437256211 |
---|---|
Provider Name | Dr. Grace Wee Lim |
First Address | Fresno, CA 93729-6180 |
Second Address | Fresno, CA 93710-7611 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 23/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A27608 | (02) | CA |
GR0070813 | (05) | CA |