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NPI Code Detail

MEDICARE: DR. MIRA LIM M.D.

MEDICARE: DR. MIRA 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
1207W00000XOphthalmology Physician235486MA
2207W00000XOphthalmology PhysicianA108588CA

General Provider Information

NPI Number : 1194987628
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MIRA LIM M.D.
Provider Business Mailing Address
First Line : 365 LENNON LN
Second Line : STE 210
City : WALNUT CREEK
State : CA
Zip : 94598-5912
Country : US
Telephone Number : 925-947-0888
Fax Number : 925-947-4385
Provider Business Practice Location Address
First Line : 365 LENNON LN
Second Line : STE 210
City : WALNUT CREEK
State : CA
Zip : 94598-5912
Country : US
Telephone Number : 925-947-0888
Fax Number : 925-947-4385
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2008
Last Update Date : 04/28/2020

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Directions to “ DR. MIRA LIM M.D.” Practice Location

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