Provider Demographics
NPI:1770589707
Name:LUM, ROBERT PATRICK (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:PATRICK
Last Name:LUM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1901 HOLSER WALK
Mailing Address - Street 2:STE 305
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-2633
Mailing Address - Country:US
Mailing Address - Phone:805-485-2824
Mailing Address - Fax:805-485-2774
Practice Address - Street 1:1901 HOLSER WALK
Practice Address - Street 2:STE 305
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-2633
Practice Address - Country:US
Practice Address - Phone:805-485-2824
Practice Address - Fax:805-485-2774
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-23
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA46608174400000X, 2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A460080Medicaid
CAA46608Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
CAG04284Medicare UPIN