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NPI Code Detail

MEDICARE: DR. MELISSA SUSANN LIM M.D.

MEDICARE: DR. MELISSA SUSANN LIM M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistG74100CA

General Provider Information

NPI Number : 1013910777
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MELISSA SUSANN LIM M.D.
Provider Business Mailing Address
First Line : 170 ALAMEDA DE LAS PULGAS
Second Line :
City : REDWOOD CITY
State : CA
Zip : 94062-2751
Country : US
Telephone Number : 650-367-5636
Fax Number : 650-367-5110
Provider Business Practice Location Address
First Line : 170 ALAMEDA DE LAS PULGAS
Second Line :
City : REDWOOD CITY
State : CA
Zip : 94062-2751
Country : US
Telephone Number : 650-367-5636
Fax Number : 650-367-5110
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2005
Last Update Date : 08/03/2011

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