Kris Lum, OD | |
4733 W Sunset Blvd, Los Angeles, CA 90027-6021 | |
(323) 783-4011 | |
Not Available |
Full Name | Kris Lum |
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Gender | Female |
Speciality | Optometrist |
Location | 4733 W Sunset Blvd, Los Angeles, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1033278767 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | OPT12332T (California) | Primary |
Provider Name | Southern California Permanente Medical Group |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1770515280 PECOS PAC ID: 6002729175 Enrollment ID: O20031110000678 |
Mailing Address | Practice Location Address |
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Kris Lum, OD 4733 W Sunset Blvd, Los Angeles, CA 90027-6021 Ph: (323) 783-4011 | Kris Lum, OD 4733 W Sunset Blvd, Los Angeles, CA 90027-6021 Ph: (323) 783-4011 |
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