DR. BRENT LEONG LUM (NPI# 1891954772) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891954772 |
| Entity Type | Individual |
| Full Name | DR. BRENT LEONG LUM |
| Credential | M.D. |
| Practice Address |
4601 Dale Rd Modesto CA 95356-9718 |
| Mailing Address |
3650 Somerset Ave Castro Valley CA 94546-3439 |
| Practice Telephone | 2094763484 |
| Practice Fax Number | 2094763012 |
| Mailing Telephone | 5108862503 |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2011-06-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | A116550 | CA | Allopathic & Osteopathic Physicians |
| N | 207W00000X | Ophthalmology | BP1-0032047 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
4601 DALE RD |
| City | MODESTO |
| State | CA |
| Zip Code | 95356-9718 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912998311 | Stephen Matthew Willey | Physical Therapist | 4601 Dale Rd, Modesto, CA 95356 | 2005-11-03 |
| 1760098263 | Paola Ramirez | Behavior Technician | 4601 Dale Rd, Modesto, CA 95356-9718 | 2020-09-20 |
| 1538772678 | Roy Choi | Pharmacist | 4601 Dale Rd, Modesto, CA 95356-9718 | 2020-08-28 |
| 1730797499 | Donna Cruz | Pharmacist | 4601 Dale Rd, Modesto, CA 95356-9718 | 2020-07-20 |
| 1538777487 | Kyle Wesley Hopson | Physical Therapist | 4601 Dale Rd, Modesto, CA 95356-9718 | 2020-07-16 |
| 1376176313 | Su Jin Yeo | Pharmacist | 4601 Dale Rd, Modesto, CA 95356-9718 | 2020-02-18 |
| 1972135580 | Tran Huyen Smernes | Pharmacist | 4601 Dale Rd, Modesto, CA 95356-9718 | 2020-02-11 |
| 1740827534 | Evelyn Kwong | Pharmacist | 4601 Dale Rd, Modesto, CA 95356-9718 | 2019-11-29 |
| 1467000463 | Oanh Hoang Nguyen Phan | Nurse Practitioner | 4601 Dale Rd, Modesto, CA 95356-9718 | 2019-09-03 |
| 1598311227 | Janine Grace Lastimosa Tennant | Pharmacist | 4601 Dale Rd, Modesto, CA 95356-9718 | 2019-08-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649809021 | Amelia E Delgadillo | Licensed Vocational Nurse | 501 Triangle Rd, Modesto, CA 95356 | 2020-04-07 |
| 1689220279 | Meagan Veneman | Physical Medicine & Rehabilitation | 125 Hogue Rd, Modesto, CA 95356 | 2019-08-10 |
| 1497131213 | Hermes Guardian Transport | Non-emergency Medical Transport (VAN) | 4221 Erin Way, Modesto, CA 95356 | 2015-08-04 |
| 1811373640 | Melissa Ruiz | Marriage & Family Therapist | 5815 Stoddard Rd Suite 600, Modesto, CA 95356 | 2015-08-04 |
| 1922242866 | Lifecare Solutions Inc | Durable Medical Equipment & Medical Supplies | 500 Glass Ln Ste H, Modesto, CA 95356 | 2009-04-22 |
| 1659541647 | Ashley Allison Streeter | Dentist | 556 Lyell Dr, Modesto, CA 95356 | 2008-03-05 |
| 1265636013 | Margaret Kathleen Grisell | Orthopaedic Surgery | 4601 Dale Ave, Kaiser Modesto Medical Center, Orthopedic Surgery, Modesto, CA 95356 | 2007-06-14 |
| 1841412111 | Bobby Gene Boswell | Specialist/Technologist | 3908 Vintage Cove, Modesto, CA 95356 | 2007-05-03 |
| 1598892861 | Merritt Radiological Medical Group Inc | Radiology | 526 Charity Way, Modesto, CA 95356 | 2007-02-27 |
| 1396871091 | Michael Steven Beck | Social Worker | 4640 Spyres Way, Building B, Suite 7, Modesto, CA 95356 | 2007-02-26 |
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| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639268089 | Keith Alan Davis | Ophthalmology | 1011 Sylvan Ave Ste C, Modesto, CA 95350-1693 | 2006-10-12 |
| 1275504524 | Brian Alexander Lenser | Ophthalmology | 3109 Coffee Rd, Ste C, Modesto, CA 95355-1766 | 2006-01-26 |
| 1194714642 | Rangram Chandran | Ophthalmology | 304 Banner Ct, Suite 1, Modesto, CA 95356-9194 | 2005-10-18 |
| 1346239803 | Anthony James Guida | Ophthalmology | 1011 Sylvan Ave, Modesto, CA 95350-1692 | 2005-10-18 |
| 1477548667 | Shi-hwa William Chang | Ophthalmology | 200 East Granger Ave, Ste 130, Modesto, CA 95350-4303 | 2005-09-14 |
| 1730591041 | Rangram Chandran Md Inc | Ophthalmology | 304 Banner Ct, Suite 1, Modesto, CA 95356-9194 | 2014-05-21 |
| 1194084517 | On-tat Lee | Ophthalmology | 1011 Sylvan Ave, Modesto, CA 95350 | 2012-05-04 |
| 1487839379 | Sylvan Eye Associates | Ophthalmology | 1011 Sylvan Ave, Modesto, CA 95350-1692 | 2008-01-09 |
| 1497878953 | Julius Mueller | Ophthalmology | 830 Scenic Dr, Modesto, CA 95350-6131 | 2007-04-09 |
| 1598800062 | James Allen Gammon | Ophthalmology | 500 Coffee Road, Suite F, Modesto, CA 95355 | 2007-02-21 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.