Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204C00000X | Sports Medicine Doctor | G85430 | CA |
N | 207RC0000X | Internist - Cardiovascular Disease | G85430 | CA |
N | 207RP1001X | Pulmonary Disease | G85430 | CA |
N | 208200000X | Surgeon | G85430 | CA |
N | 208600000X | Surgeon | G85430 | CA |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | G85430 | CA |
NPI | 1982608238 |
---|---|
Provider Name | Dr. Herve J. Dumont |
First Address | Los Angeles, CA 90029-1701 |
Second Address | Los Angeles, CA 90029-1701 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2005 |
Last Update Date | 28/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G854300 | (05) | CA |
F54511 | (02) | CA |