Provider Demographics
NPI:1235340308
Name:LIM, DAVID (MD PHD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:LIM
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 OWENS ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94158-2261
Mailing Address - Country:US
Mailing Address - Phone:415-734-4886
Mailing Address - Fax:
Practice Address - Street 1:400 PARNASSUS AVE BOX 0378
Practice Address - Street 2:AMBULATORY CARE CENTER
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-0378
Practice Address - Country:US
Practice Address - Phone:415-353-2119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA96161282N00000X, 261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty