Individual
DALE M STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9281 OFFICE PARK CIR, #120, ELK GROVE, CA 95758-8068
(916) 691-5999
(916) 691-6717
Mailing address
10470 OLD PLACERVILLE RD, SUITE 100, SACRAMENTO, CA 95827-2539
(800) 470-0071
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A41495
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A414950
—
CA
Enumeration date
09/20/2006
Last updated
05/12/2015
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