Provider Demographics
NPI:1902188691
Name:STARK, AARON (RPH)
Entity Type:Individual
Prefix:MR
First Name:AARON
Middle Name:
Last Name:STARK
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6744 ESTRELLA DE MAR RD
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-5203
Mailing Address - Country:US
Mailing Address - Phone:760-429-5308
Mailing Address - Fax:
Practice Address - Street 1:3752 MISSION AVE
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92058-1417
Practice Address - Country:US
Practice Address - Phone:760-722-9409
Practice Address - Fax:760-722-9416
Is Sole Proprietor?:No
Enumeration Date:2011-09-19
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA048762183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist