MEDICARE: DR. JULIE RACHEL STARK D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	2OA6747	CA

General Provider Information

NPI Number	:	1689718017
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JULIE RACHEL STARK D.O.

Provider Business Mailing Address
First Line	:	5731 RIDGEBROOK DR
Second Line	:
City	:	AGOURA
State	:	CA
Zip	:	91301-4619
Country	:	US
Telephone Number	:	818-706-9700
Fax Number	:	805-374-1423

Provider Business Practice Location Address
First Line	:	2125 E THOUSAND OAKS BLVD
Second Line	:	SUITE A
City	:	THOUSAND OAKS
State	:	CA
Zip	:	91362-2942
Country	:	US
Telephone Number	:	805-374-1420
Fax Number	:	805-374-1423

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/18/2007
Last Update Date	:	01/11/2026

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