Stark, Dale M

Stark, Dale M is an individual health care provider with primary practice located at 9281 Office Park Cir #120, Elk Grove CA 95758-8068. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Stark, Dale M can be contacted via phone (916) 691-5999.

Contact Information

Primary practice address
9281 Office Park Cir #120 Elk Grove CA 95758-8068
Phone: (916) 691-5999
Fax: (916) 691-6717
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X A41495 California

Profile Details

NPI number 1598862526
LBN Legal business name Stark, Dale M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2006
Last updated May 12th, 2015 - about 9 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 1598862526 NPPES
California MEDICAID 00A414950

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