Provider Demographics
NPI:1700319332
Name:LIM, SENJOUNG (LAC)
Entity Type:Individual
Prefix:
First Name:SENJOUNG
Middle Name:
Last Name:LIM
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12065 LAMPLIGHTER LN
Mailing Address - Street 2:
Mailing Address - City:OAK HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92344-8690
Mailing Address - Country:US
Mailing Address - Phone:626-826-1800
Mailing Address - Fax:
Practice Address - Street 1:2727 W 6TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-3111
Practice Address - Country:US
Practice Address - Phone:213-738-1974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-10
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC15203171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist