Basic Information
| Provider Information | |||||||||
| NPI: | 1033444302 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LIS A ZIN STARK, M.D., INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1007 | ||||||||
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| City: | MURRIETA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925641007 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9517193330 | ||||||||
| FaxNumber: | 9512966706 | ||||||||
| Practice Location | |||||||||
| Address1: | 8555 FLORENCE AVE | ||||||||
| Address2: | |||||||||
| City: | DOWNEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902404014 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5629239351 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2009 | ||||||||
| LastUpdateDate: | 10/05/2009 | ||||||||
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| AuthorizedOfficialLastName: | STARK | ||||||||
| AuthorizedOfficialFirstName: | LIS | ||||||||
| AuthorizedOfficialMiddleName: | A ZIN | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5629239351 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207XS0106X | A41411 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Hand Surgery |
No ID Information.