Provider Demographics
NPI:1366554537
Name:LUM, GREGORY FRANCIS (MD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:FRANCIS
Last Name:LUM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 320925
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-0115
Mailing Address - Country:US
Mailing Address - Phone:408-370-2324
Mailing Address - Fax:
Practice Address - Street 1:15000 LOS GATOS BLVD STE 3
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-2017
Practice Address - Country:US
Practice Address - Phone:408-370-2324
Practice Address - Fax:408-370-2385
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG 78511208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics