Provider Demographics
NPI:1679746887
Name:LIM, SNA (DC)
Entity Type:Individual
Prefix:
First Name:SNA
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 1:1150 W ROBINHOOD DR
Mailing Address - Street 2:SUITE 4A
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95207-5624
Mailing Address - Country:US
Mailing Address - Phone:916-662-4887
Mailing Address - Fax:
Practice Address - Street 1:1150 W ROBINHOOD DR
Practice Address - Street 2:SUITE 4A
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-5624
Practice Address - Country:US
Practice Address - Phone:916-662-4887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30813111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor