MEDICARE: DR. RACHEL LIM DMD

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
1	122300000X	Dentist	63594	CA
2	1223E0200X	Endodontics	63594	CA

General Provider Information

NPI Number	:	1033526918
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RACHEL LIM DMD

Provider Business Mailing Address
First Line	:	3684 ROADRUNNER DR
Second Line	:
City	:	BREA
State	:	CA
Zip	:	92823-1041
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5449 HOLLYWOOD BLVD STE A
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-3454
Country	:	US
Telephone Number	:	323-391-1390
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2014
Last Update Date	:	02/29/2024

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Directions to “ DR. RACHEL LIM DMD” Practice Location

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