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General NPI Number Information
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NPI Number | 1275261067
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Entity Type | Organization
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Legal Business Name | JUNGJAE LIM MEDICAL CORPORATION
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Dates
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Enumeration Date | 08/10/2022
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Last Update Date | 12/07/2023
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Provider Practice Location Address
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Address Line | 10700 BALBOA BLVD STE 102
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City | GRANADA HILLS
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State | CA
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Zip | 91344-5024
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Country | US
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Telephone | 818-826-4145
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Fax | 818-338-2807
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Provider Business Mailing Address
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Address Line | 10700 BALBOA BLVD STE 102
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City | GRANADA HILLS
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State | CA
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Zip | 91344-5024
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Country | US
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Telephone | 818-826-4145
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Fax | 818-338-2807
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Authorized Official
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Title or Position | MD
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Name | DR. JUNGJAE LIM
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Credential | MD
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Telephone | 818-826-4145
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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