Healthcare Provider Details

I. General information

NPI: 1811004559
Provider Name (Legal Business Name): PAULA JOY LUM M.D., M.P.H.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

995 POTRERO AVE BUILDING 80, WARD 84
SAN FRANCISCO CA
94110-2859
US

IV. Provider business mailing address

995 POTRERO AVE BUILDING 80, WARD 84
SAN FRANCISCO CA
94110-2859
US

V. Phone/Fax

Practice location:
  • Phone: 415-206-2400
  • Fax: 415-476-6953
Mailing address:
  • Phone: 415-206-2400
  • Fax: 415-476-6953

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License NumberA53746
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA53746
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: