Provider Demographics
NPI:1134257850
Name:STUMP AND AHMADPOUR
Entity type:Organization
Organization Name:STUMP AND AHMADPOUR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:HED
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMADPOUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-925-8407
Mailing Address - Street 1:PO BOX 801463
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91380-1463
Mailing Address - Country:US
Mailing Address - Phone:661-295-0859
Mailing Address - Fax:866-431-1210
Practice Address - Street 1:3300 E SOUTH ST
Practice Address - Street 2:SUITE 303
Practice Address - City:LAKEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90805-4549
Practice Address - Country:US
Practice Address - Phone:562-925-8407
Practice Address - Fax:562-925-1723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA30282207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Not Answered207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA30282OtherPARTNER LICENSE#