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General NPI Number Information
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NPI Number | 1689029563
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Entity Type | Individual
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Provider Name | JUNGJAE LIM M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/28/2016
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Last Update Date | 11/16/2022
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Provider Practice Location Address
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Address Line | 10700 BALBOA BLVD
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City | GRANADA HILLS
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State | CA
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Zip | 91344
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Country | US
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Telephone | 818-366-6550
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Fax | 818-366-6555
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Provider Business Mailing Address
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Address Line | 10700 BALBOA BLVD
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City | GRANADA HILLS
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State | CA
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Zip | 91344
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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 |
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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 | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | A160584
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License Number State | CA
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