Organization
RANDY W STARK MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDY W STARK MD (PRESIDENT)
(805) 563-3011
Entity
Organization
Contact information
Practice address
221 MAHALANI ST, WAILUKU, HI 96793-2526
(208) 463-5100
Mailing address
3916 STATE ST, #300, SANTA BARBARA, CA 93105-5602
(805) 563-3011
(805) 564-5087
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
630287
—
HI
Enumeration date
12/06/2008
Last updated
06/16/2009
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