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General NPI Number Information
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NPI Number | 1902035181
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Entity Type | Organization
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Legal Business Name | STEPHEN IRA STARK, M.D., INC
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Dates
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Enumeration Date | 07/08/2009
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Last Update Date | 02/16/2010
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Provider Practice Location Address
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Address Line | 2825 J ST SUITE 235
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City | SACRAMENTO
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State | CA
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Zip | 95816-4300
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Country | US
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Telephone | 916-446-3777
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Fax | 916-446-3788
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Provider Business Mailing Address
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Address Line | 2825 J ST SUITE 235
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City | SACRAMENTO
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State | CA
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Zip | 95816-4300
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Country | US
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Telephone | 916-446-3777
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Fax | 916-446-3788
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Authorized Official
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Title or Position | CPA
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Name | CATHERINE L PATRICK
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Credential |
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Telephone | 916-920-1604
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | G60200
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License Number State | CA
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