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NPI Code Detail

MEDICARE: STARBRIGHT MEDICAL CLINIC INC

MEDICARE: STARBRIGHT MEDICAL CLINIC INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207QG0300XGeriatric Medicine (Family Medicine) Physician

General Provider Information

NPI Number : 1902605108
Entity Type Code : Organization
Provider Name (Legal Business Name) : STARBRIGHT MEDICAL CLINIC INC
Provider Business Mailing Address
First Line : 17071 VENTURA BLVD STE 104
Second Line :
City : ENCINO
State : CA
Zip : 91316-4142
Country : US
Telephone Number : 213-852-6006
Fax Number :
Provider Business Practice Location Address
First Line : 17071 VENTURA BLVD STE 104
Second Line :
City : ENCINO
State : CA
Zip : 91316-4142
Country : US
Telephone Number : 213-852-6006
Fax Number :
Authorized Official
Title or Position : CEO/OWNER
Name : ABDUL RAB KHAN
Credential : MD
Telephone Number : 213-852-6006
Provider Enumeration Date : 03/10/2025
Last Update Date : 03/10/2025

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Directions to “STARBRIGHT MEDICAL CLINIC INC ” Practice Location

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