Healthcare Provider Details

I. General information

NPI: 1184888299
Provider Name (Legal Business Name): PAMELA G. STARNES, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2008
Last Update Date: 07/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4560 ADMIRALTY WAY STE. 108
MARINA DEL REY CA
90292-5423
US

IV. Provider business mailing address

PO BOX 7001
TARZANA CA
91357-7001
US

V. Phone/Fax

Practice location:
  • Phone: 310-827-3564
  • Fax: 310-823-1099
Mailing address:
  • Phone: 818-888-7815
  • Fax: 818-715-1722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA68996
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberA68996
License Number StateCA

VIII. Authorized Official

Name: PAMELA STARNES
Title or Position: PRESIDENT SOLE OWNER
Credential: M.D.
Phone: 818-888-7815