Healthcare Provider Details

I. General information

NPI: 1346314416
Provider Name (Legal Business Name): CAROLE LEWIS STOLPE B.C.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 11/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 N BEDFORD DR SUITE 411
BEVERLY HILLS CA
90210-4321
US

IV. Provider business mailing address

435 N BEDFORD DR SUITE 411
BEVERLY HILLS CA
90210-4321
US

V. Phone/Fax

Practice location:
  • Phone: 310-271-8801
  • Fax: 310-271-6189
Mailing address:
  • Phone: 310-271-8801
  • Fax: 310-271-6189

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1700X
TaxonomyOcularist
License Number89-227-07
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: