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General NPI Number Information
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NPI Number | 1356470058
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Entity Type | Individual
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Provider Name | DR. GERALDINE ANN LIM
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Gender | Female
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 8227 DAY CREEK BLVD SUITE 100
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91739-8567
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Country | US
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Telephone | 909-899-0245
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Fax | 909-899-1293
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Provider Business Mailing Address
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Address Line | 5625 BERYL ST
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City | ALTA LOMA
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State | CA
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Zip | 91737-2112
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Country | US
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Telephone | 909-899-0245
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Fax | 909-899-1293
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 9485T
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License Number State | CA
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