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13569 Poway Rd Poway CA 92064-4715 | |
| (858) 486-3300 | |
| (858) 486-5300 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 13569 Poway Rd, Poway, California |
| Authorized Official Name and Position | Jhang H. Lim (PRESIDENT) |
| Authorized Official Contact | 8584863300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
13569 Poway Rd Poway CA 92064-4715 Ph: (858) 486-3300 | 13569 Poway Rd Poway CA 92064-4715 Ph: (858) 486-3300 |
| NPI Number | 1801192208 |
|---|---|
| Provider Enumeration Date | 02/02/2011 |
| Last Update Date | 02/02/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801192208 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 30384 (California) | Primary |
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