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Individual

STEPHEN STARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
500 UNIVERSITY AVE STE 104, SACRAMENTO, CA 95825-6504
(916) 425-0404
(916) 678-6762
Mailing address
88 COVERED BRIDGE RD, CARMICHAEL, CA 95608-5218
(916) 425-0404
(916) 678-6762

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
G60200
CA
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
G60200
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G602000
CA
01
A53563
UPIN
CA
Enumeration date
06/09/2006
Last updated
07/21/2022
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