1497018782 NPI number — DENNIS STOLPNER M.D.

Table of content: DENNIS STOLPNER M.D. (NPI 1497018782)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497018782 NPI number — DENNIS STOLPNER M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STOLPNER
Provider First Name:
DENNIS
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497018782
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/21/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2171 S. EL CAMINO REAL
Provider Second Line Business Mailing Address:
SUITE 104
Provider Business Mailing Address City Name:
OCEANSIDE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92054-6269
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
760-754-5663
Provider Business Mailing Address Fax Number:
760-754-5440

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1200 N. TUSTIN AVE
Provider Second Line Business Practice Location Address:
SUITE 130
Provider Business Practice Location Address City Name:
SANTA ANA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92705-3501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
657-600-9077
Provider Business Practice Location Address Fax Number:
657-600-9076
Provider Enumeration Date:
06/21/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208D00000X , with the licence number:  156847 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208D00000X , with the licence number: A156847 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com