Provider Demographics
NPI:1932324878
Name:SPARKUHL, MICHAEL D (MD)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:D
Last Name:SPARKUHL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5855 OLIVAS PARK DR
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-7672
Mailing Address - Country:US
Mailing Address - Phone:805-667-2801
Mailing Address - Fax:805-667-2865
Practice Address - Street 1:242 E HARVARD BLVD STE C
Practice Address - Street 2:
Practice Address - City:SANTA PAULA
Practice Address - State:CA
Practice Address - Zip Code:93060-3372
Practice Address - Country:US
Practice Address - Phone:805-525-9595
Practice Address - Fax:805-525-6667
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2015-05-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG29928208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA44222Medicare UPIN
CAAS513VMedicare Oscar/Certification