Provider Demographics
NPI:1821425265
Name:LIM, MICHELLE SARA (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:SARA
Last Name:LIM
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10120 ALONDRA BLVD
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-3904
Mailing Address - Country:US
Mailing Address - Phone:714-624-9424
Mailing Address - Fax:
Practice Address - Street 1:10120 ALONDRA BLVD
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-3904
Practice Address - Country:US
Practice Address - Phone:714-624-9424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-30
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32729111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor