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General NPI Number Information
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NPI Number | 1982360285
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Entity Type | Individual
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Provider Name | MICHELLE LIM PHARMD
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Gender | Female
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Dates
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Enumeration Date | 11/10/2021
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Last Update Date | 11/10/2021
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Provider Practice Location Address
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Address Line | 115 LAKE BLVD E
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City | REDDING
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State | CA
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Zip | 96003-2913
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Country | US
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Telephone | 530-229-1519
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Fax |
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Provider Business Mailing Address
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Address Line | 2741 SMITH AVE
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City | SHASTA LAKE
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State | CA
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Zip | 96019-2142
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Country | US
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Telephone | 562-716-3596
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH85374
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License Number State | CA
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