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General NPI Number Information
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NPI Number | 1952088684
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Entity Type | Organization
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Legal Business Name | STAR MEDICAL ASSOCIATES, A MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 07/04/2023
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Last Update Date | 07/04/2023
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Provider Practice Location Address
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Address Line | 1701 W VERDUGO AVE
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City | BURBANK
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State | CA
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Zip | 91506-2147
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Country | US
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Telephone | 310-488-2830
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Fax |
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Provider Business Mailing Address
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Address Line | 4312 WOODMAN AVE STE 102
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City | SHERMAN OAKS
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State | CA
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Zip | 91423-5523
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Country | US
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Telephone | 310-488-2830
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. ANTHONY CARDILLO
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Credential | MD
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Telephone | 310-488-2830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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