Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 55290 | CA |
Y | 213EG0000X | General Practice | 55290 | CA |
NPI | 1003010372 |
---|---|
Provider Name | Dr. Kyung A Lim |
First Address | Los Angeles, CA 90005-4941 |
Second Address | Los Angeles, CA 90005-4941 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2007 |
Last Update Date | 08/07/2007 |