Stark, Bruce M

Stark, Bruce M is an individual health care provider with primary practice located at 201 S Buena Vista St Suite 300, Burbank CA 91505-4569. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Addiction Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Stark, Bruce M can be contacted via phone (818) 842-7145.

Contact Information

Primary practice address
201 S Buena Vista St Suite 300 Burbank CA 91505-4569
Phone: (818) 842-7145
Fax: (818) 842-8202
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X G72204 California
Allopathic & Osteopathic Physicians / Addiction Medicine 207RA0401X G72204 California

Profile Details

NPI number 1902801301
LBN Legal business name Stark, Bruce M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2005
Last updated Oct 13th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902801301 NPPES
California MEDICAID 00G722040

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