Healthcare Provider Details

I. General information

NPI: 1669439246
Provider Name (Legal Business Name): PHILIP A STARR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 07/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 PARNASSUS AVE
SAN FRANCISCO CA
94143-2202
US

IV. Provider business mailing address

1635 DIVISADERO ST STE 625, BOX 1821
SAN FRANCISCO CA
94143-0001
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-7500
  • Fax: 415-353-2889
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberG84550
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: