MEDICARE: DR. PHILLIP EDWARD STARSHAK MD

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
1	207ZH0000X	Hematology (Pathology) Physician	A103569	CA
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	A103569	CA

General Provider Information

NPI Number	:	1699708214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PHILLIP EDWARD STARSHAK MD

Provider Business Mailing Address
First Line	:	316 S DUNWORTH ST
Second Line	:
City	:	VISALIA
State	:	CA
Zip	:	93292-6702
Country	:	US
Telephone Number	:	559-625-0601
Fax Number	:

Provider Business Practice Location Address
First Line	:	316 S DUNWORTH ST
Second Line	:
City	:	VISALIA
State	:	CA
Zip	:	93292-6702
Country	:	US
Telephone Number	:	559-625-0601
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2006
Last Update Date	:	12/17/2021

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