Provider Demographics
NPI:1417638768
Name:DENNIS STOLPNER MD INC
Entity type:Organization
Organization Name:DENNIS STOLPNER MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:STOLPNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-475-5077
Mailing Address - Street 1:11420 DONA TERESA DR
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-4271
Mailing Address - Country:US
Mailing Address - Phone:323-475-5077
Mailing Address - Fax:
Practice Address - Street 1:6221 WILSHIRE BLVD STE 504
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-5223
Practice Address - Country:US
Practice Address - Phone:323-965-9995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-28
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth ServiceGroup - Single Specialty