Healthcare Provider Details

I. General information

NPI: 1205270154
Provider Name (Legal Business Name): ALLSTAR HEALTH PROVIDERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2013
Last Update Date: 04/10/2023
Certification Date: 04/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10722 ARROW RTE STE 218
RANCHO CUCAMONGA CA
91730-4810
US

IV. Provider business mailing address

5787 LITTLE SHAY DR
FONTANA CA
92336-4593
US

V. Phone/Fax

Practice location:
  • Phone: 909-945-9899
  • Fax: 909-945-9799
Mailing address:
  • Phone: 909-945-9899
  • Fax: 909-945-9799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number550002526
License Number StateCA

VIII. Authorized Official

Name: MARIA CATHERINE KOH CHUA
Title or Position: CFO/HR DIRECTOR
Credential:
Phone: 909-945-9899