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General NPI Number Information
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NPI Number | 1730444720
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Entity Type | Organization
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Legal Business Name | BRIGHTSTAR CSD, LLC
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Dates
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Enumeration Date | 07/06/2012
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Last Update Date | 07/06/2012
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Provider Practice Location Address
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Address Line | 5830 OBERLIN DR SUITE 204
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City | SAN DIEGO
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State | CA
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Zip | 92121-3703
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Country | US
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Telephone | 858-777-9525
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Fax | 858-777-9551
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Provider Business Mailing Address
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Address Line | 5830 OBERLIN DR SUITE 204
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City | SAN DIEGO
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State | CA
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Zip | 92121-3703
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Country | US
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Telephone | 858-777-9525
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Fax | 858-777-9551
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Authorized Official
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Title or Position | OWNER
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Name | SHELLY SUN
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Credential |
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Telephone | 847-693-2040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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