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NPI Code Detail

MEDICARE: MS. SU LIM

MEDICARE:  MS. SU  LIM
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1528291648
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SU LIM
Provider Business Mailing Address
First Line : 848 5TH ST
Second Line : APT 10
City : SANTA MONICA
State : CA
Zip : 90403-1357
Country : US
Telephone Number : 310-880-9199
Fax Number :
Provider Business Practice Location Address
First Line : 848 5TH ST
Second Line : APT 10
City : SANTA MONICA
State : CA
Zip : 90403-1357
Country : US
Telephone Number : 310-880-9199
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2009
Last Update Date : 08/25/2009

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Directions to “ MS. SU LIM ” Practice Location

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