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NPI Code Detail

MEDICARE: DR. CATHERINE KAY LUM M.D.

MEDICARE: DR. CATHERINE KAY LUM 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
12080P0205XPediatric Endocrinology PhysicianMD27725OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MD27725OTHERORLICENSE
2G83092OTHERCALICENSE

General Provider Information

NPI Number : 1295719193
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CATHERINE KAY LUM M.D.
Provider Business Mailing Address
First Line : 3550 N INTERSTATE AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97227-1196
Country : US
Telephone Number : 503-285-9321
Fax Number : 503-249-5286
Provider Business Practice Location Address
First Line : 3550 N INTERSTATE AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97227-1196
Country : US
Telephone Number : 503-285-9321
Fax Number : 503-249-5286
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2005
Last Update Date : 08/18/2015

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