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General NPI Number Information
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NPI Number | 1508510777
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Entity Type | Organization
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Legal Business Name | GOLDSTAR DIAGNOSTICS
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Dates
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Enumeration Date | 02/07/2022
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Last Update Date | 02/08/2022
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Provider Practice Location Address
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Address Line | 1050 MURRIETA BLVD
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City | LIVERMORE
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State | CA
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Zip | 94550-4111
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Country | US
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Telephone | 925-413-7046
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Fax |
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Provider Business Mailing Address
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Address Line | 2863 95TH ST # 143-159
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City | NAPERVILLE
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State | IL
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Zip | 60564-9005
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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 | OWNER/ CHAIRMAN
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Name | RAHEEL ISRAR
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Credential |
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Telephone | 925-413-7046
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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