Healthcare Provider Details

I. General information

NPI: 1760349864
Provider Name (Legal Business Name): CHRISTOPHER JAMES LIM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2026
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 PARNASSUS AVE
SAN FRANCISCO CA
94143-2204
US

IV. Provider business mailing address

197 PINEHAVEN DR
DALY CITY CA
94015-3564
US

V. Phone/Fax

Practice location:
  • Phone: 650-731-2022
  • Fax:
Mailing address:
  • Phone: 650-731-2022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberINT52148
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: