Provider Demographics
NPI:1275822066
Name:AMY LUMENG, M.D., INC.
Entity Type:Organization
Organization Name:AMY LUMENG, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:F
Authorized Official - Last Name:LUMENG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-778-5438
Mailing Address - Street 1:909 KAPIOLANI BLVD
Mailing Address - Street 2:APARTMENT 2707
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-2199
Mailing Address - Country:US
Mailing Address - Phone:808-778-5438
Mailing Address - Fax:
Practice Address - Street 1:405 N KUAKINI ST
Practice Address - Street 2:SUITE 1103
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-6300
Practice Address - Country:US
Practice Address - Phone:808-778-5438
Practice Address - Fax:808-440-2255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-01
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-11345207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty