Provider Demographics
NPI:1053672212
Name:LUM, WALANIKA (PHARMD, RPH, RN)
Entity Type:Individual
Prefix:DR
First Name:WALANIKA
Middle Name:
Last Name:LUM
Suffix:
Gender:F
Credentials:PHARMD, RPH, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17016 BIRDS EYE DR
Mailing Address - Street 2:
Mailing Address - City:PERRIS
Mailing Address - State:CA
Mailing Address - Zip Code:92570-7376
Mailing Address - Country:US
Mailing Address - Phone:951-888-0443
Mailing Address - Fax:
Practice Address - Street 1:17016 BIRDS EYE DR
Practice Address - Street 2:
Practice Address - City:PERRIS
Practice Address - State:CA
Practice Address - Zip Code:92570-7376
Practice Address - Country:US
Practice Address - Phone:951-888-0443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA616911835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist