Healthcare Provider Details

I. General information

NPI: 1346565868
Provider Name (Legal Business Name): CHRISTIAN ALVIN LIM PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2010
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 WHITNEY PLACE
FREMONT CA
94539
US

IV. Provider business mailing address

740 RYAN TERRACE
SAN RAMON CA
94583
US

V. Phone/Fax

Practice location:
  • Phone: 510-490-6988
  • Fax: 708-460-8863
Mailing address:
  • Phone: 630-920-4670
  • Fax: 630-920-4687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number291560
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070017693
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: