Provider Demographics
NPI:1225564487
Name:LIM, ATALIE M (MD, MBBS)
Entity Type:Individual
Prefix:
First Name:ATALIE
Middle Name:M
Last Name:LIM
Suffix:
Gender:F
Credentials:MD, MBBS
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3400 DATA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4240 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:CA
Practice Address - Zip Code:92346-2764
Practice Address - Country:US
Practice Address - Phone:909-864-4700
Practice Address - Fax:909-425-4195
Is Sole Proprietor?:No
Enumeration Date:2017-05-10
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA167226208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics