Provider Demographics
NPI:1114124724
Name:LIM, JONG HYUK (AC)
Entity Type:Individual
Prefix:DR
First Name:JONG
Middle Name:HYUK
Last Name:LIM
Suffix:
Gender:M
Credentials:AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:649 W IMPERIAL HWY STE A2
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-3838
Mailing Address - Country:US
Mailing Address - Phone:714-990-8988
Mailing Address - Fax:714-482-0405
Practice Address - Street 1:649 W IMPERIAL HWY STE A2
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-3838
Practice Address - Country:US
Practice Address - Phone:714-990-8988
Practice Address - Fax:714-482-0405
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC5823171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist