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NPI Code Detail

MEDICARE: DR. MICHAEL J STAR M.D.

MEDICARE: DR. MICHAEL J STAR M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery PhysicianE85482CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1G61167OTHERCALICENSE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
300G611670OTHERCACIGNA DME

General Provider Information

NPI Number : 1194768747
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL J STAR M.D.
Provider Business Mailing Address
First Line : 1405 MONTGOMERY DR
Second Line :
City : SANTA ROSA
State : CA
Zip : 95405-4557
Country : US
Telephone Number : 707-546-1922
Fax Number : 707-546-1987
Provider Business Practice Location Address
First Line : 1405 MONTGOMERY DR
Second Line :
City : SANTA ROSA
State : CA
Zip : 95405-4557
Country : US
Telephone Number : 707-546-1922
Fax Number : 707-546-1987
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2006
Last Update Date : 11/25/2008

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