Provider Demographics
NPI:1659743938
Name:LUM, SHARON
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:LUM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:
Other - Last Name:HUANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:130 TALMONT CIR
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-6059
Mailing Address - Country:US
Mailing Address - Phone:808-255-6338
Mailing Address - Fax:
Practice Address - Street 1:1400 LEAD HILL BLVD
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-2949
Practice Address - Country:US
Practice Address - Phone:916-724-0021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-26
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA72168183500000X
HIPH3834183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist