MEDICARE: MR. SOKHA LIM DOK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator	NOLICENSE
2	225400000X	Rehabilitation Practitioner

General Provider Information

NPI Number	:	1013052349
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SOKHA LIM DOK

Provider Business Mailing Address
First Line	:	1922 THE ALAMEDA STE 302
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95126-1461
Country	:	US
Telephone Number	:	408-261-7777
Fax Number	:	408-642-6052

Provider Business Practice Location Address
First Line	:	438 N WHITE RD
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95127-1439
Country	:	US
Telephone Number	:	408-254-6828
Fax Number	:	408-642-6052

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2007
Last Update Date	:	06/27/2025

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