Active NPI
Justin Lim, DC
- Chiropractor
- Montclair, CA
National Provider Identifier
1235992116
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC36869
- Practice address
- 4959 Palo Verde St Ste 100B
Montclair, CA 91763-2339 - Phone
- (909) 626-7100
- Fax
- (909) 626-0123
- NPI assigned
- Feb 2, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC36869 | CA | Primary |
Addresses
Primary practice location
4959 Palo Verde St Ste 100B
Montclair, CA 91763-2339
Mailing address
13881 Dellbrook St
Eastvale, CA 92880-3161
Phone (714) 822-0902
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC36869 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1706832000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710979200000",
"number": "1235992116",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13881 DELLBROOK ST",
"city": "EASTVALE",
"state": "CA",
"postal_code": "928803161",
"telephone_number": "714-822-0902"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4959 PALO VERDE ST STE 100B",
"city": "MONTCLAIR",
"state": "CA",
"postal_code": "917632339",
"telephone_number": "909-626-7100",
"fax_number": "909-626-0123"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIM",
"first_name": "JUSTIN",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-02-02",
"last_updated": "2024-03-21",
"certification_date": "2024-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC36869",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montclair, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.