Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 48743 | CA |
NPI | 1235352071 |
---|---|
Provider Name | Dr. Joseph Daekeun Lim |
First Address | Torrance, CA 90501-7128 |
Second Address | Torrance, CA 90501-7128 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2007 |
Last Update Date | 08/07/2007 |