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:
Health care specialties
Specialty | Code | License # | 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 last year |
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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1902801301 | NPPES |
California | MEDICAID | 00G722040 |
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