MEDICARE: DR. LUN W HOM 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	2086X0206X	Surgical Oncology Physician	A20593	CA

General Provider Information

NPI Number	:	1821078544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LUN W HOM M.D.

Provider Business Mailing Address
First Line	:	PO BOX 30
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90801-0030
Country	:	US
Telephone Number	:	562-426-0301
Fax Number	:	562-426-9882

Provider Business Practice Location Address
First Line	:	2865 ATLANTIC AVE.
Second Line	:	#108
City	:	LONG BEACH
State	:	CA
Zip	:	90806-0030
Country	:	US
Telephone Number	:	562-426-0301
Fax Number	:	562-426-9882

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

Provider Enumeration Date	:	01/19/2006
Last Update Date	:	07/08/2007

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