Provider Demographics
NPI:1457770760
Name:LIM, DANIEL CHI HUNG (PHARMD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:CHI HUNG
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 1:225 COLON AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94112-1307
Mailing Address - Country:US
Mailing Address - Phone:415-342-0369
Mailing Address - Fax:
Practice Address - Street 1:720 SUTTON WAY
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-5393
Practice Address - Country:US
Practice Address - Phone:530-273-7399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-15
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA67292183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist