Provider Demographics
NPI:1982693958
Name:LIM, ELSIE YANG (PT)
Entity type:Individual
Prefix:MS
First Name:ELSIE
Middle Name:YANG
Last Name:LIM
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:ELSIE
Other - Middle Name:YANG
Other - Last Name:LIM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:827 BAY HARBOUR DR
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94065-1764
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 REDWOOD SHORES PKWY
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94065-1100
Practice Address - Country:US
Practice Address - Phone:650-593-2800
Practice Address - Fax:650-593-0152
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT85782251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic