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General NPI Number Information
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NPI Number | 1750735676
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Entity Type | Individual
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Provider Name | YOONCHAN CHRISTIAN LIM RPH
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Gender | Male
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Dates
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Enumeration Date | 04/17/2016
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Last Update Date | 04/17/2016
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Provider Practice Location Address
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Address Line | 4535 HOLT BLVD
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City | MONTCLAIR
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State | CA
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Zip | 91763-4710
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Country | US
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Telephone | 909-624-4177
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Fax | 909-626-9454
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Provider Business Mailing Address
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Address Line | 4535 HOLT BLVD
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City | MONTCLAIR
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State | CA
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Zip | 91763-4710
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Country | US
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Telephone | 909-624-4177
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Fax | 909-626-9454
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH 53307
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License Number State | CA
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