Healthcare Provider Details

I. General information

NPI: 1588527709
Provider Name (Legal Business Name): MISS ANITA ESTHER LUM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 E 36TH ST
LOS ANGELES CA
90011-2326
US

IV. Provider business mailing address

333 E 36TH ST
LOS ANGELES CA
90011-2326
US

V. Phone/Fax

Practice location:
  • Phone: 323-501-6071
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number95402616
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: