Individual
DR. KELLIE JANE LIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7471 N FRESNO ST, FRESNO, CA 93720-2457
(559) 436-4500
(559) 436-0500
Mailing address
7471 N FRESNO ST, FRESNO, CA 93720-2457
(559) 436-4500
(559) 436-0500
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
A106613
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0043790
—
CA
01
—
ZZZ21572Z
MEDICARE PTAN
CA
Enumeration date
07/13/2007
Last updated
06/24/2013
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