Organization
DR. DERRICK G. LIM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DERRICK GUY LIM (OWNER)
(562) 422-3378
Entity
Organization
Contact information
Practice address
5657 ATLANTIC AVE, LONG BEACH, CA 90805-4710
(562) 422-3378
Mailing address
5657 ATLANTIC AVE, LONG BEACH, CA 90805-4710
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
10509T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0105091
—
CA
Enumeration date
07/08/2006
Last updated
03/17/2009
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