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General NPI Number Information
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NPI Number | 1982839155
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Entity Type | Organization
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Legal Business Name | DUET PLASTIC SURGERY, A MEDICAL CORPORATION
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Dates
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Enumeration Date | 05/18/2009
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Last Update Date | 05/18/2009
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Provider Practice Location Address
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Address Line | 515 SOUTH DR SUITE 25
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94040-4204
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Country | US
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Telephone | 650-380-0415
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Fax | 650-964-2205
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Provider Business Mailing Address
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Address Line | 515 SOUTH DR SUITE 25
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94040-4204
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Country | US
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Telephone | 650-380-0415
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Fax | 650-964-2205
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANGELINE LIM
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Credential | M.D.
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Telephone | 650-380-0415
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | A83918, A84000
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License Number State | CA
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