Provider Demographics
NPI:1871463596
Name:LIM, PHIC KAING (PHARMD)
Entity type:Individual
Prefix:DR
First Name:PHIC
Middle Name:KAING
Last Name:LIM
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:529 FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:LA CANADA FLINTRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91011-3507
Mailing Address - Country:US
Mailing Address - Phone:626-217-0188
Mailing Address - Fax:
Practice Address - Street 1:529 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:LA CANADA FLINTRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91011-3507
Practice Address - Country:US
Practice Address - Phone:626-217-0188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-07
Last Update Date:2025-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA491751835C0207X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835C0207XPharmacy Service ProvidersPharmacistCompounded Sterile Preparations
No183500000XPharmacy Service ProvidersPharmacist