Individual provider Active NPI

Marcus Wesley Lum, MD

  • Family Medicine Physician
  • La Mirada, CA
National Provider Identifier
1003839242
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G073347 Issued in CA
Practice address
15034 Imperial Hwy
La Mirada, CA 90638-1301
Phone
(562) 902-3000
Fax
(562) 902-9563
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G073347 CA Primary

Addresses

Primary practice location

15034 Imperial Hwy
La Mirada, CA 90638-1301

Mailing address

15034 Imperial Hwy
La Mirada, CA 90638-1301
Phone (562) 902-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101108001331 CA Practitioner - Family Practice 3072588912 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Imperial Primary Care Medical GroupGroup PAC ID 3476528316, 4 clinicians

Practice addresses (Care Compare)

15625 Imperial Hwy
La Mirada, CA 90638-1627
Phone 5629023000233

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G073347CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Imperial Primary Care Medical Group Family Medicine CurrentSince Nov 30, 2000 Accepting new patients
Ahmc Whittier Hospital Medical Center LP Past Accepting new patients
St Jude Hospital Inc Past Accepting new patients
Anaheim Memorial Medical Center Past Accepting new patients
Pih Health Whittier Hospital Past Accepting new patients

Locations

15625 Imperial Hwy
La Mirada, CA 90638
Phone (562) 902-3000

15034 Imperial Hwy
La Mirada, CA 90638
Phone (562) 902-3000

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10008746
  • Direct secure messaging: marcuslum@ipcmg.allscriptsdirect.net

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003839242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15034 IMPERIAL HWY",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906381301",
            "telephone_number": "562-902-3000",
            "fax_number": "562-902-9563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15034 IMPERIAL HWY",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906381301",
            "telephone_number": "562-902-3000",
            "fax_number": "562-902-9563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUM",
        "first_name": "MARCUS",
        "middle_name": "WESLEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G073347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mirada, CA

Sources for this page

Verify at the official NPI Registry.