Provider Demographics
NPI:1477701555
Name:LIM, CHUNG (DC)
Entity Type:Individual
Prefix:DR
First Name:CHUNG
Middle Name:
Last Name:LIM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2233 HUNTINGTON DR STE 9
Mailing Address - Street 2:
Mailing Address - City:SAN MARINO
Mailing Address - State:CA
Mailing Address - Zip Code:91108-2655
Mailing Address - Country:US
Mailing Address - Phone:626-441-1800
Mailing Address - Fax:626-441-1802
Practice Address - Street 1:2233 HUNTINGTON DR STE 9
Practice Address - Street 2:
Practice Address - City:SAN MARINO
Practice Address - State:CA
Practice Address - Zip Code:91108-2655
Practice Address - Country:US
Practice Address - Phone:626-441-1800
Practice Address - Fax:626-441-1802
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-03
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30917111N00000X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
No111N00000XChiropractic ProvidersChiropractor