Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LP2300X | Nurse Practitioner - Primary Care | NPF1887 | CA |
NPI | 1003964743 |
---|---|
Provider Name | Ms. Lillian G. Lum-Kaku |
First Address | San Francisco, CA 94122-1616 |
Second Address | San Francisco, CA 94122-1616 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
047407 | SFGH INTERNAL USE ONLY-COMMERCIAL NUMBER (01) | |
P85317 | (02) |