Healthcare Provider Details

I. General information

NPI: 1760456446
Provider Name (Legal Business Name): DALE R STEMPLE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 01/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 TRINITY LAKES BLVD
WEAVERVILLE CA
96093
US

IV. Provider business mailing address

PO BOX 496084
REDDING CA
96049-6084
US

V. Phone/Fax

Practice location:
  • Phone: 530-623-6777
  • Fax: 530-623-5120
Mailing address:
  • Phone: 530-241-0473
  • Fax: 530-241-5377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberC36399
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: