Healthcare Provider Details

I. General information

NPI: 1093057499
Provider Name (Legal Business Name): GRACE XIAO'EN LIM MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2013
Last Update Date: 07/03/2025
Certification Date: 07/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2672 BAYSHORE PKWY STE 608
MOUNTAIN VIEW CA
94043-1017
US

IV. Provider business mailing address

2672 BAYSHORE PKWY STE 608
MOUNTAIN VIEW CA
94043-1017
US

V. Phone/Fax

Practice location:
  • Phone: 754-702-7256
  • Fax: 844-204-0781
Mailing address:
  • Phone: 754-702-7256
  • Fax: 844-204-0781

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA143319
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: