Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | DOS-1665 | HI |
N | 207RC0000X | Internist - Cardiovascular Disease | DOS-1665 | HI |
NPI | 1952668220 |
---|---|
Provider Name | Dr. Corey Jonathan Lum |
First Address | Honolulu, HI 96813 |
Second Address | Honolulu, HI 96813-2423 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2012 |
Last Update Date | 02/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
819493 | (05) | HI |