Provider Demographics
NPI:1043356330
Name:LIM, HOON (DC)
Entity Type:Individual
Prefix:DR
First Name:HOON
Middle Name:
Last Name:LIM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:HOON
Other - Middle Name:
Other - Last Name:LIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:205 W MISSION AVE
Mailing Address - Street 2:SUITE P
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-1733
Mailing Address - Country:US
Mailing Address - Phone:760-480-0077
Mailing Address - Fax:760-480-0379
Practice Address - Street 1:205 W MISSION AVE
Practice Address - Street 2:SUITE P
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-1733
Practice Address - Country:US
Practice Address - Phone:760-480-0077
Practice Address - Fax:760-480-0379
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC16695111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC16695Medicare UPIN
CAT18389Medicare ID - Type Unspecified