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Chari Diana Stump

Pediatrics

Allopathic & Osteopathic Physicians

7910 Frost St Ste 400, San Diego, CA 92123-2753

PECOS Enrollment

This provider is enrolled in PECOS as CHARI STUMP.

Based on the most recent information from CMS, provider Chari Diana Stump is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 2:29 PM.

Profile Details

Provider ID
1265968788
Provider Type
Individual
Full Name
Stump, Chari Diana
Credential
M.D.

Gender
Female
Sole Proprietor
No
Enumeration Date
5/3/2017
Last Updated
3/2/2022

Contact Information

Practice Location

7910 Frost St Ste 400, San Diego, CA 92123-2753

(858) 495-0500

Unlisted Fax

Mailing Location

11280 Vista Sorrento Pkwy Apt 100, San Diego, CA 92130-7638

(301) 908-6519

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 208000000X Primary	Description Pediatrics Allopathic & Osteopathic Physicians	License A173107 California
Code 208M00000X	Description Hospitalist Allopathic & Osteopathic Physicians	License D0089953 Maryland
Code 208000000X	Description Pediatrics Allopathic & Osteopathic Physicians	License 0101269267 Virginia

Chari Diana Stump

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

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