Healthcare Provider Details

I. General information

NPI: 1275147233
Provider Name (Legal Business Name): ZACHARY LIM MB, BCH, BAO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2020
Last Update Date: 11/27/2023
Certification Date: 09/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2550 23RD ST BLDG 92ND
SAN FRANCISCO CA
94110-3504
US

IV. Provider business mailing address

525 NELSON RISING LANE APT 504
SAN FRANCISCO CA
94158
US

V. Phone/Fax

Practice location:
  • Phone: 628-206-8812
  • Fax:
Mailing address:
  • Phone: 647-528-4908
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License Number170079
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: