Provider Demographics
NPI:1154535722
Name:LUM, MICHAEL (DO)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:LUM
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Gender:M
Credentials:DO
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Mailing Address - Street 1:23639 HAWTHORNE BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-5930
Mailing Address - Country:US
Mailing Address - Phone:310-375-9595
Mailing Address - Fax:310-375-2138
Practice Address - Street 1:23639 HAWTHORNE BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-5930
Practice Address - Country:US
Practice Address - Phone:310-375-9595
Practice Address - Fax:310-375-2138
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2010-01-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA20A8557207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine