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General NPI Number Information
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NPI Number | 1467813295
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Entity Type | Organization
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Legal Business Name | LUM ACUPUNCTURE AND HERBAL MEDICINE
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Dates
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Enumeration Date | 03/07/2016
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Last Update Date | 11/02/2017
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Provider Practice Location Address
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Address Line | 16101 VENTURA BLVD STE 343
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City | ENCINO
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State | CA
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Zip | 91436-2516
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Country | US
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Telephone | 505-917-9292
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Fax |
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Provider Business Mailing Address
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Address Line | 16101 VENTURA BLVD STE 343
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City | ENCINO
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State | CA
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Zip | 91436-2516
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Country | US
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Telephone | 505-917-9292
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KRISTEN LUM
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Credential | LAC
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Telephone | 505-917-9292
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 1185
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | AC17604
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License Number State | CA
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