Provider Demographics
NPI:1497018782
Name:STOLPNER, DENNIS (MD)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:
Last Name:STOLPNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2171 S. EL CAMINO REAL
Mailing Address - Street 2:SUITE 104
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-6269
Mailing Address - Country:US
Mailing Address - Phone:760-754-5663
Mailing Address - Fax:760-754-5440
Practice Address - Street 1:1200 N. TUSTIN AVE
Practice Address - Street 2:SUITE 130
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-3501
Practice Address - Country:US
Practice Address - Phone:657-600-9077
Practice Address - Fax:657-600-9076
Is Sole Proprietor?:No
Enumeration Date:2012-06-21
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA156847208D00000X
CAA156847208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice