Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 7218 | AZ |
Y | 213EG0000X | General Practice | 7218 | AZ |
N | 1223G0001X | General Practice | 7713 | CO |
N | 213EG0000X | General Practice | 7713 | CO |
NPI | 1003037540 |
---|---|
Provider Name | Shaun Hoon Lim |
First Address | Surprize, AZ 85379 |
Second Address | Surprize, AZ 85379 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2007 |
Last Update Date | 08/07/2007 |