Active NPI
Bruce Stump, M.D.
- Anesthesiology Physician
- Stockton, CA
National Provider Identifier
1477582237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- G50331
- Practice address
- 2626 N California St
Suite G
Stockton, CA 95204-5500 - Phone
- (209) 464-9846
- Fax
- (209) 464-4082
- NPI assigned
- Jul 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | G50331 | CA | Primary |
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | G50331 | CA |
Addresses
Primary practice location
2626 N California St
Suite G
Stockton, CA 95204-5500
Mailing address
2626 N California St
Suite G
Stockton, CA 95204-5500
Phone (209) 464-9846
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G503310 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50331 | CA | MD | General Practice Dentistry |
| G50331 | CA | MD | Pain Medicine (Anesthesiology) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Delta Radiology, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Specialist
- Lodi, CA
- NPI 1881728327
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191888000000",
"number": "1477582237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2626 N CALIFORNIA ST",
"address_2": "SUITE G",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952045500",
"telephone_number": "209-464-9846",
"fax_number": "209-464-4082"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2626 N CALIFORNIA ST",
"address_2": "SUITE G",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952045500",
"telephone_number": "209-464-9846",
"fax_number": "209-464-4082"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STUMP",
"first_name": "BRUCE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-02",
"last_updated": "2007-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CA",
"license": "G50331",
"primary": true
},
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "CA",
"license": "G50331",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G503310",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Stockton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.