Provider Demographics
NPI:1508927633
Name:YUMENA, LUCIA FLORES (MD)
Entity Type:Individual
Prefix:DR
First Name:LUCIA
Middle Name:FLORES
Last Name:YUMENA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2557 MOWRY AVE STE 33
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1614
Mailing Address - Country:US
Mailing Address - Phone:510-745-8100
Mailing Address - Fax:510-797-4983
Practice Address - Street 1:2557 MOWRY AVE STE 33
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1614
Practice Address - Country:US
Practice Address - Phone:510-745-8100
Practice Address - Fax:510-797-4983
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2010-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA39976207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A399760Medicaid
CA00A399760Medicaid
00A399760Medicare ID - Type Unspecified