Active NPI
Deana Emiko Lum, O.D.
- Optometrist
- Fresno, CA
National Provider Identifier
1225140858
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1541
- Practice address
- 2615 E Clinton Ave
Surgical Service 112
Fresno, CA 93703-2223 - Phone
- (559) 225-6100
- NPI assigned
- Aug 31, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1541 | AZ | Primary |
Addresses
Primary practice location
2615 E Clinton Ave
Surgical Service 112
Fresno, CA 93703-2223
Mailing address
1823 McCluhan Way
San Jose, CA 95132-1536
Phone (408) 802-6996
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1541 | AZ | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209513600000",
"number": "1225140858",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1823 MCCLUHAN WAY",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951321536",
"telephone_number": "408-802-6996"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2615 E CLINTON AVE",
"address_2": "SURGICAL SERVICE 112",
"city": "FRESNO",
"state": "CA",
"postal_code": "937032223",
"telephone_number": "559-225-6100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUM",
"first_name": "DEANA",
"middle_name": "EMIKO",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-31",
"last_updated": "2008-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "AZ",
"license": "1541",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.