Individual
STEVEN RAY SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9434 MEDICAL CENTER DR, LA JOLLA, CA 92037-1337
(858) 552-8585
Mailing address
PO BOX 232410, SAN DIEGO, CA 92193-2410
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
G073184
CA
2086S0129X
Vascular Surgery Physician
Primary
G073184
CA
Other
Enumeration date
09/29/2010
Last updated
09/08/2017
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