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NPI Code Detail

MEDICARE: CAROL ANNE LIM GNP

MEDICARE: CAROL ANNE LIM GNP
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
1363LG0600XGerontology Nurse Practitioner469377CA

General Provider Information

NPI Number : 1710979190
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROL ANNE LIM GNP
Provider Business Mailing Address
First Line : 251 DANTLEY WAY
Second Line :
City : WALNUT CREEK
State : CA
Zip : 94598-1804
Country : US
Telephone Number : 925-945-0497
Fax Number : 415-292-8845
Provider Business Practice Location Address
First Line : 1333 BUSH ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94109-5611
Country : US
Telephone Number : 415-292-8888
Fax Number : 415-292-8845
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2005
Last Update Date : 01/27/2011

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