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Individual

BRYANT JAY LUM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3088 TELEGRAPH RD, SUITE A, VENTURA, CA 93003-3234
(805) 648-6891
(805) 648-6386
Mailing address
3088 TELEGRAPH RD, SUITE A, VENTURA, CA 93003-3234
(805) 648-6891
(805) 648-6386

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
A45040
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
ZZZ41333Z
BLUE SHIELD
CA
Enumeration date
06/15/2006
Last updated
12/22/2010
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