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Organization
SPARKS MEDICAL CORP
Active
Organization
SPARKS MEDICAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD SPARKS MD (PRESIDENT)
(310) 956-9980
Entity
Organization
Contact information
Practice address
8906 SAN BERNARDINO RD STE 140, RANCHO CUCAMONGA, CA 91730-8806
(909) 204-2797
Mailing address
PO BOX 10173, TORRANCE, CA 90505-0973
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
03/11/2025
Last updated
03/11/2025
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