Provider Demographics
NPI:1407251291
Name:LIM, JOSHUA H (LAC)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:H
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 1:15501 SAN FERNANDO MISSION BLVD
Mailing Address - Street 2:SUITE 311
Mailing Address - City:MISSION HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91345-1359
Mailing Address - Country:US
Mailing Address - Phone:213-399-8782
Mailing Address - Fax:
Practice Address - Street 1:15501 SAN FERNANDO MISSION BLVD
Practice Address - Street 2:SUITE 311
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345-1359
Practice Address - Country:US
Practice Address - Phone:213-399-8782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-23
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC15546171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist