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General NPI Number Information
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NPI Number | 1013101500
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Entity Type | Individual
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Provider Name | REBECCA ANNE STARK MD
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Gender | Female
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Dates
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Enumeration Date | 08/28/2007
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Last Update Date | 07/20/2016
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Provider Practice Location Address
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Address Line | 2521 STOCKTON BLVD UCDMC GLASSROCK PEDS. SURGERY - SUITE 3200
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City | SACRAMENTO
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State | CA
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Zip | 95817-2207
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Country | US
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Telephone | 916-734-3229
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Fax |
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Provider Business Mailing Address
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Address Line | 2221 STOCKTON BLVD UCDMC CYPRESS BLDG., 3RD FLOOR
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City | SACRAMENTO
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State | CA
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Zip | 95817-1418
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Country | US
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Telephone | 916-734-3229
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0120X
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Taxonomy Name | Pediatric Surgery Physician
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License Number | A109860
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License Number State | CA
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