Individual
JENNIFER P. LUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
94-1480 MOANIANI ST, WAIPAHU, HI 96797-4632
(808) 432-3100
Mailing address
94-1480 MOANIANI ST, WAIPAHU, HI 96797-4632
(808) 432-3100
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
242494
MA
207V00000X
Obstetrics & Gynecology Physician
MD13194
RI
207V00000X
Obstetrics & Gynecology Physician
Primary
MD14342
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001492801
MEDICARE PTAN
RI
05
—
JL79120
—
RI
Enumeration date
02/12/2007
Last updated
06/03/2021
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