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General NPI Number Information
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NPI Number | 1336048594
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Entity Type | Organization
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Legal Business Name | LUMEN PHYSICIAN SPECIALISTS INC
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Dates
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Enumeration Date | 11/04/2026
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Last Update Date | 11/04/2026
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Provider Practice Location Address
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Address Line | 1798 N GAREY AVE
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City | POMONA
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State | CA
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Zip | 91767-2918
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Country | US
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Telephone | 909-326-7907
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 485
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City | LA VERNE
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State | CA
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Zip | 91750-0485
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Country | US
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Telephone | 909-326-7907
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | DR. RAMANNA MERLA
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Credential | MD
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Telephone | 909-326-7907
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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