Sparc

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

6052976 Issued in CA

Legal business name

SPARC

Practice address

363 Main St # B
Redwood City, CA 94063-1729

Phone

(650) 780-0575

NPI assigned

Feb 1, 2007

Organization subpart

No

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

Authorized official

Name

Mark Sontag, M.D.

Title

Owner

Phone

(650) 780-0575

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lauren Denenberg, RPT

  • Physical Therapist
  • Redwood City, CA
  • NPI 1235256983
  NPD (past)
• Robert Durazzo, MFT

  • Marriage & Family Therapist
  • Redwood City, CA
  • NPI 1831211424
  NPD (past)
• Diane Helen Hafner, DC

  • Chiropractor
  • Redwood City, CA
  • NPI 1073527420
  NPD (past)

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1780722199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "363 MAIN ST # B",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940631729",
            "telephone_number": "650-780-0575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "363 MAIN ST # B",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940631729",
            "telephone_number": "650-780-0575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SONTAG",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "650-780-0575",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "CA",
            "license": "6052976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tariku Mulugeta Sory, LVN
• Katherine Soto
• Mayra Alejandra Soto, LCSW
• Cecily Koppuzha Sotomayor, M.D.
• Southbay Pain & Sports Medicine Acupuncture
• Skyler Spears
• Amanda Speedy
• Karla Priscilla Spinelli Machado Martins
• Rose Spinna
• Tatiana Worobey Spirtos, M.D.

• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Redwood City, CA
• Providers in Redwood City, CA by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) 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.