Provider Demographics
NPI:1811004559
Name:LUM, PAULA JOY (MD, MPH)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:JOY
Last Name:LUM
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:995 POTRERO AVE
Mailing Address - Street 2:BUILDING 80, WARD 84
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-2859
Mailing Address - Country:US
Mailing Address - Phone:415-206-2400
Mailing Address - Fax:415-476-6953
Practice Address - Street 1:995 POTRERO AVE
Practice Address - Street 2:BUILDING 80, WARD 84
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-2859
Practice Address - Country:US
Practice Address - Phone:415-206-2400
Practice Address - Fax:415-476-6953
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA53746207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A537460Medicaid
G49547Medicare UPIN
CA00A537460Medicaid