Healthcare Provider Details

I. General information

NPI: 1073398004
Provider Name (Legal Business Name): AARON C LIM PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2023
Last Update Date: 08/28/2023
Certification Date: 08/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

482 N ROSEMEAD BLVD STE 207
PASADENA CA
91107-3053
US

IV. Provider business mailing address

482 N ROSEMEAD BLVD STE 207
PASADENA CA
91107-3053
US

V. Phone/Fax

Practice location:
  • Phone: 310-564-6278
  • Fax:
Mailing address:
  • Phone: 310-564-6278
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPSY34307
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY34307
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: