Provider Demographics
NPI:1427365410
Name:LUM, BERNADINE R (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:BERNADINE
Middle Name:R
Last Name:LUM
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1880 S PACIFIC COAST HWY
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-6117
Mailing Address - Country:US
Mailing Address - Phone:310-316-6849
Mailing Address - Fax:310-316-2952
Practice Address - Street 1:1880 S PACIFIC COAST HWY
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-6117
Practice Address - Country:US
Practice Address - Phone:310-316-6849
Practice Address - Fax:310-316-2952
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-11
Last Update Date:2010-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 459441835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy