Provider Demographics
NPI:1033414230
Name:LIM, CHUNHWAN (LAC)
Entity Type:Individual
Prefix:DR
First Name:CHUNHWAN
Middle Name:
Last Name:LIM
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2675 W OLYMPIC BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006-2880
Mailing Address - Country:US
Mailing Address - Phone:213-200-6336
Mailing Address - Fax:213-896-7485
Practice Address - Street 1:2675 W OLYMPIC BLVD STE 201
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-2880
Practice Address - Country:US
Practice Address - Phone:213-200-6336
Practice Address - Fax:213-896-7485
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-19
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 11288171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist