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NPI Code Detail

MEDICARE: BARNIE Y LIM O.D.

MEDICARE: BARNIE Y LIM O.D.
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
1152W00000XOptometrist007523NY
2152W00000XOptometrist12501TCA

General Provider Information

NPI Number : 1790709418
Entity Type Code : Individual
Provider Name (Legal Business Name) : BARNIE Y LIM O.D.
Provider Business Mailing Address
First Line : 3841 BRICKWAY BLVD
Second Line : SANTA ROSA VA CBOC EYE CLINIC
City : SANTA ROSA
State : CA
Zip : 95403-8226
Country : US
Telephone Number : 707-569-2300
Fax Number :
Provider Business Practice Location Address
First Line : 3841 BRICKWAY BLVD
Second Line : SANTA ROSA VA CBOC EYE CLINIC
City : SANTA ROSA
State : CA
Zip : 95403-8226
Country : US
Telephone Number : 707-569-2300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2006
Last Update Date : 05/25/2015

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