Provider Demographics
NPI:1164752275
Name:LUMIER MEDICAL INC.
Entity Type:Organization
Organization Name:LUMIER MEDICAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LUM
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:310-375-9595
Mailing Address - Street 1:23639 HAWTHORNE BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-5930
Mailing Address - Country:US
Mailing Address - Phone:310-375-9595
Mailing Address - Fax:310-375-2138
Practice Address - Street 1:23639 HAWTHORNE BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-5930
Practice Address - Country:US
Practice Address - Phone:310-375-9595
Practice Address - Fax:310-375-2138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-12
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A8557207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty