Active NPI
Yoonchan Christian Lim, RPH
- Pharmacist
- Montclair, CA
National Provider Identifier
1750735676
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH 53307
- Practice address
- 4535 Holt Blvd
Montclair, CA 91763-4710 - Phone
- (909) 624-4177
- Fax
- (909) 626-9454
- NPI assigned
- Apr 17, 2016
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH 53307 | CA | Primary |
Addresses
Primary practice location
4535 Holt Blvd
Montclair, CA 91763-4710
Mailing address
4535 Holt Blvd
Montclair, CA 91763-4710
Phone (909) 624-4177
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH 53307 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Garfield Beach CVS LLC | Past | Accepting new patients | |
| Garfield Beach CVS, L.L.C. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1460851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1460851200000",
"number": "1750735676",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4535 HOLT BLVD",
"city": "MONTCLAIR",
"state": "CA",
"postal_code": "917634710",
"telephone_number": "909-624-4177",
"fax_number": "909-626-9454"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4535 HOLT BLVD",
"city": "MONTCLAIR",
"state": "CA",
"postal_code": "917634710",
"telephone_number": "909-624-4177",
"fax_number": "909-626-9454"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIM",
"first_name": "YOONCHAN",
"middle_name": "CHRISTIAN",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-04-17",
"last_updated": "2016-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "RPH 53307",
"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 Apr 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.