Healthcare Provider Details

I. General information

NPI: 1235340308
Provider Name (Legal Business Name): DAVID LIM MD PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 07/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 PARNASSUS AVE BOX 0378 AMBULATORY CARE CENTER
SAN FRANCISCO CA
94143-0378
US

IV. Provider business mailing address

1650 OWENS ST
SAN FRANCISCO CA
94158-2261
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-2119
  • Fax:
Mailing address:
  • Phone: 415-734-4886
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberA96161
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberA96161
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: