Provider Demographics
NPI:1558019430
Name:LIM, SHARON (NP-C)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:LIM
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22320 HARBOR RIDGE LN UNIT 2
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90502-2492
Mailing Address - Country:US
Mailing Address - Phone:213-215-5489
Mailing Address - Fax:
Practice Address - Street 1:2780 SKYPARK DR STE 115
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-5342
Practice Address - Country:US
Practice Address - Phone:310-530-7244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-10
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95016159363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily