Provider Demographics
NPI:1588996318
Name:LIM, BRIAN
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:LIM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 KAPIOLANI BLVD
Mailing Address - Street 2:SUITE # 1660
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-3801
Mailing Address - Country:US
Mailing Address - Phone:808-944-1117
Mailing Address - Fax:808-944-1119
Practice Address - Street 1:1600 KAPIOLANI BLVD
Practice Address - Street 2:SUITE # 1660
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-3801
Practice Address - Country:US
Practice Address - Phone:808-944-1117
Practice Address - Fax:808-944-1119
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-04
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1169111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor