Healthcare Provider Details

I. General information

NPI: 1306733738
Provider Name (Legal Business Name): STAR ALLIANCE MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2025
Last Update Date: 06/19/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 WEST LEGION ROAD
BRAWLEY CA
92227
US

IV. Provider business mailing address

PO BOX 27518
ANAHEIM CA
92809
US

V. Phone/Fax

Practice location:
  • Phone: 760-351-8669
  • Fax: 760-351-8894
Mailing address:
  • Phone: 760-351-8669
  • Fax: 760-351-8894

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. SAYED MONIS
Title or Position: OWNER
Credential: MD
Phone: 760-351-8669