Healthcare Provider Details

I. General information

NPI: 1003119330
Provider Name (Legal Business Name): S&L MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2010
Last Update Date: 10/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7232 VAN NUYS BLVD STE 203
VAN NUYS CA
91405-2231
US

IV. Provider business mailing address

7232 VAN NUYS BLVD STE 203
VAN NUYS CA
91405-2231
US

V. Phone/Fax

Practice location:
  • Phone: 818-947-5955
  • Fax: 818-947-5961
Mailing address:
  • Phone: 818-947-5955
  • Fax: 818-947-5961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberA50038
License Number StateCA

VIII. Authorized Official

Name: DR. SEUNG H LIM
Title or Position: CEO
Credential: M.D.
Phone: 818-400-9327