Randy W Stark MD Inc

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

RANDY W STARK MD INC

Practice address

221 Mahalani St
Wailuku, HI 96793-2526

Phone

(208) 463-5100

NPI assigned

Dec 6, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Randy W Stark, MD

Title

President

Phone

(805) 563-3011

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1228521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245110400000",
    "number": "1295970143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3916 STATE ST",
            "address_2": "#300",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931055602",
            "telephone_number": "805-563-3011",
            "fax_number": "805-564-5087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 MAHALANI ST",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967932526",
            "telephone_number": "208-463-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDY W STARK MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-06",
        "last_updated": "2009-06-16",
        "status": "A",
        "authorized_official_last_name": "STARK",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-563-3011",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": "HI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "630287",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Randy F Niklason MD Inc
• Richard Rasmussen, DDS
• Robert D Reader, LMT
• Jonathan B. Redenbaugh, D.O.
• Kristin M. Redenbaugh, DO
• Helen Rempel, PAC

• Emergency Medicine Physician in Wailuku, HI
• Providers in Wailuku, HI by specialty
• Emergency Medicine Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.