Individual
DR. MICHAEL A STARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1808 VERDUGO BLVD., SUITE 313, GLENDALE, CA 91208-1463
(818) 952-6183
(818) 952-3603
Mailing address
1808 VERDUGO BLVD., SUITE 313, GLENDALE, CA 91208-1463
(818) 952-6183
(818) 952-3603
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
G33213
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G332130
—
CA
Enumeration date
05/01/2007
Last updated
07/08/2007
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