Individual
DR. BRUCE M STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
201 S BUENA VISTA ST, SUITE 300, BURBANK, CA 91505-4569
(818) 842-7145
(818) 842-8202
Mailing address
201 S BUENA VISTA ST, SUITE 300, BURBANK, CA 91505-4569
(818) 842-7145
(818) 842-8202
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G72204
CA
207RA0401X
Addiction Medicine (Internal Medicine) Physician
G72204
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G722040
—
CA
Enumeration date
06/14/2005
Last updated
10/13/2023
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