Provider Demographics
NPI:1144753781
Name:LIM, DANNY JOONSANG (PA-C)
Entity type:Individual
Prefix:MR
First Name:DANNY
Middle Name:JOONSANG
Last Name:LIM
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:15301 WARREN SHINGLE RD
Mailing Address - Street 2:
Mailing Address - City:BEALE AFB
Mailing Address - State:CA
Mailing Address - Zip Code:95903-1905
Mailing Address - Country:US
Mailing Address - Phone:530-634-2092
Mailing Address - Fax:530-634-4763
Practice Address - Street 1:15301 WARREN SHINGLE RD
Practice Address - Street 2:
Practice Address - City:BEALE AFB
Practice Address - State:CA
Practice Address - Zip Code:95903-1905
Practice Address - Country:US
Practice Address - Phone:530-634-4156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-11
Last Update Date:2025-09-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAPA65463363A00000X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant