MEDICARE: DR. ROBERT PATRICK LUM M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	A46608	CA
2	2085R0001X	Radiation Oncology Physician	A46608	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770589707
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT PATRICK LUM M.D.

Provider Business Mailing Address
First Line	:	1901 HOLSER WALK
Second Line	:	STE 305
City	:	OXNARD
State	:	CA
Zip	:	93036-2633
Country	:	US
Telephone Number	:	805-485-2824
Fax Number	:	805-485-2774

Provider Business Practice Location Address
First Line	:	1901 HOLSER WALK
Second Line	:	STE 305
City	:	OXNARD
State	:	CA
Zip	:	93036-2633
Country	:	US
Telephone Number	:	805-485-2824
Fax Number	:	805-485-2774

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	08/16/2023

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