Provider Demographics
NPI:1720251184
Name:RIM, SEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:
Last Name:RIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4440 SEPULVEDA BLVD
Mailing Address - Street 2:APT 217
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-3903
Mailing Address - Country:US
Mailing Address - Phone:917-468-6893
Mailing Address - Fax:
Practice Address - Street 1:435 N ROXBURY DR
Practice Address - Street 2:STE 100
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-5027
Practice Address - Country:US
Practice Address - Phone:917-468-6893
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-08
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY257737208600000X
CAA123588208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery