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General NPI Number Information
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NPI Number | 1467772012
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Entity Type | Organization
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Legal Business Name | MARK L STARR MD A MEDICAL CORPORATION
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Dates
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Enumeration Date | 06/06/2010
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Last Update Date | 06/06/2010
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Provider Practice Location Address
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Address Line | 2220 LYNN RD 105
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-1904
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Country | US
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Telephone | 805-496-6699
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Fax |
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Provider Business Mailing Address
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Address Line | 2220 LYNN RD 105
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-1904
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARK STARR
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Credential |
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Telephone | 805-496-6699
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | G40513
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | G40513
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | G40513
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License Number State | CA
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