Michael a. Stark M.D. a Medical Corporation

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

G33213 Issued in CA

Legal business name

MICHAEL A. STARK M.D. A MEDICAL CORPORATION

Practice address

1808 Verdugo Blvd
Suite 313
Glendale, CA 91208-1477

Phone

(818) 952-6183

Fax

(818) 952-3603

NPI assigned

Apr 15, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Michael A Stark, M.D

Title

President

Phone

(818) 952-6183

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1176595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346465531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1808 VERDUGO BLVD",
            "address_2": "SUITE 313",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912081477",
            "telephone_number": "818-952-6183",
            "fax_number": "818-952-3603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1808 VERDUGO BLVD",
            "address_2": "SUITE 313",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912081477",
            "telephone_number": "818-952-6183",
            "fax_number": "818-952-3603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL A. STARK M.D. A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STARK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-952-6183",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "G33213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G332130",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Cardiovascular Disease Physician in Glendale, CA
• Providers in Glendale, CA by specialty
• Cardiovascular Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.