Provider Demographics
NPI:1427089192
Name:LIM, VICKI (ATC)
Entity type:Individual
Prefix:MS
First Name:VICKI
Middle Name:
Last Name:LIM
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1527 LAKME AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:CA
Mailing Address - Zip Code:90744-1526
Mailing Address - Country:US
Mailing Address - Phone:310-540-0847
Mailing Address - Fax:
Practice Address - Street 1:1527 LAKME AVE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:CA
Practice Address - Zip Code:90744-1526
Practice Address - Country:US
Practice Address - Phone:310-540-0847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist