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General NPI Number Information
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NPI Number | 1477435329
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Entity Type | Individual
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Provider Name | MR. LESLEY LIM
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Gender | Male
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Dates
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Enumeration Date | 07/22/2025
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 12538 ECKLESON ST
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City | CERRITOS
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State | CA
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Zip | 90703-7848
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Country | US
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Telephone | 562-900-0949
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Fax |
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Provider Business Mailing Address
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Address Line | 12538 ECKLESON ST
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City | CERRITOS
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State | CA
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Zip | 90703-7848
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Country | US
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Telephone | 562-900-0949
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Fax |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 95036191
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License Number State | CA
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