Provider Demographics
NPI:1235342247
Name:STARK, JAMES B (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:B
Last Name:STARK
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Gender:M
Credentials:MD
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Mailing Address - Street 1:909 HYDE STREET
Mailing Address - Street 2:SUITE 432
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109
Mailing Address - Country:US
Mailing Address - Phone:415-441-6321
Mailing Address - Fax:415-441-6527
Practice Address - Street 1:909 HYDE ST
Practice Address - Street 2:SUITE 432
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-4822
Practice Address - Country:US
Practice Address - Phone:415-441-6321
Practice Address - Fax:415-441-6527
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA312792081H0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081H0002XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA31279OtherLICENCE