Provider Demographics
NPI:1215902457
Name:LIM, WELMAN T (DPM)
Entity type:Individual
Prefix:DR
First Name:WELMAN
Middle Name:T
Last Name:LIM
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:131 N EL MOLINO AVE
Mailing Address - Street 2:SUITE 230
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-1873
Mailing Address - Country:US
Mailing Address - Phone:626-792-4432
Mailing Address - Fax:626-792-0301
Practice Address - Street 1:131 N EL MOLINO AVE
Practice Address - Street 2:SUITE 230
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-1873
Practice Address - Country:US
Practice Address - Phone:626-792-4432
Practice Address - Fax:626-792-0301
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-21
Last Update Date:2008-07-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAE2785213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E27850Medicaid
CA000E27850Medicaid
CAT19235Medicare UPIN
CA1085950001Medicare NSC