Provider Demographics
NPI:1982608238
Name:DUMONT, HERVE J (MD)
Entity Type:Individual
Prefix:DR
First Name:HERVE
Middle Name:J
Last Name:DUMONT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1155 N VERMONT AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90029-1701
Mailing Address - Country:US
Mailing Address - Phone:323-664-1814
Mailing Address - Fax:323-663-1723
Practice Address - Street 1:1155 N VERMONT AVE
Practice Address - Street 2:STE 200
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90029-1701
Practice Address - Country:US
Practice Address - Phone:323-664-1814
Practice Address - Fax:323-663-1723
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-01
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG85430204C00000X, 207RC0000X, 207RP1001X, 208600000X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G854300Medicaid
CAG85430Medicare ID - Type Unspecified
CA00G854300Medicaid