Provider Demographics
NPI:1144505637
Name:LIM, MICHAEL CAESAR (RPH)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:CAESAR
Last Name:LIM
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:495 FREMONT STREET
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89101-5609
Mailing Address - Country:US
Mailing Address - Phone:702-385-1284
Mailing Address - Fax:702-385-1634
Practice Address - Street 1:495 FREMONT STREET
Practice Address - Street 2:170
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89101-5609
Practice Address - Country:US
Practice Address - Phone:702-385-1284
Practice Address - Fax:702-385-1634
Is Sole Proprietor?:No
Enumeration Date:2011-10-15
Last Update Date:2011-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV14496183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist