=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386713501
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | STARPOINT HEALTH, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/06/2006
-----------------------------------------------------
Last Update Date | 01/14/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 14400 BEAR VALLEY RD
-----------------------------------------------------
City | VICTORVILLE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92392-5470
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-951-5162
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 19000 MACARTHUR BLVD
-----------------------------------------------------
City | IRVINE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92612-1438
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-705-5105
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIEF EXECUTIVE OFFICER
-----------------------------------------------------
Name | MR. ERIC FRIEDLANDER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 949-705-5105
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QA1903X
-----------------------------------------------------
Taxonomy Name | Ambulatory Surgical Clinic/Center
-----------------------------------------------------
License Number | 240000389
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------