STARKS MEDICAL GROUP A PROFESSIONAL CORPORATION (NPI# 1649714734) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649714734 |
| Entity Type | Organization |
| Organization Name | STARKS MEDICAL GROUP A PROFESSIONAL CORPORATION |
| Practice Address |
5153 Holt Blvd Suite B2 Montclair CA 91763-4837 |
| Practice Telephone | 9096250661 |
| Practice Fax Number | 9096257761 |
| Mailing Telephone | 9096250661 |
| Mailing Fax Number | 9096257761 |
| Enumeration Date | 2016-12-08 |
| Last Update Date | 2016-12-08 |
| Authorized Official Name | DR. BRIAN K GAMBLE (PRESIDENT) |
| Authorized Official Telephone | 9096250661 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 208D00000X | General Practice | Allopathic & Osteopathic Physicians | ||
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
A76121 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
5153 HOLT BLVD SUITE B2 |
| City | MONTCLAIR |
| State | CA |
| Zip Code | 91763-4837 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720050842 | Sodabeh Rahimy | Internal Medicine | 5153 Holt Blvd, Suite B1, Montclair, CA 91763-4837 | 2006-02-02 |
| 1467756353 | Holt Dental Center | Dentist | 5153 Holt Blvd, A2, Montclair, CA 91763-4837 | 2011-01-06 |
| 1639308679 | Holt Dental Center | Dentist | 5153 Holt Blvd, Suit A2, Montclair, CA 91763 | 2009-07-13 |
| 1154555795 | D Starks Md Incorporated | Clinic/Center | 5153 Holt Blvd, Suite B-2, Montclair, CA 91763-4837 | 2009-05-12 |
| 1922206283 | Eastwest Physical Therapy Inc | Clinic/Center | 5153 Holt Blvd, Suite A-1, Montclair, CA 91763-4837 | 2007-07-10 |
| 1568682003 | Cecille Ho | Dentist | 5153 Holt Blvd, A2, Montclair, CA 91763-4820 | 2007-04-26 |
| 1689719957 | Ifeoma Ugwu | Pharmacist | 5153 Holt Blvd, Suite A-6, Montclair, CA 91763-4820 | 2007-02-21 |
| 1205873866 | Dung Tran | Physical Therapist | 5153 Holt Blvd, A-1, Montclair, CA 91763-4837 | 2006-06-01 |
| 1831140847 | Orie Inc. | Pharmacy | 5153 Holt Blvd, Ste A6, Montclair, CA 91763-4837 | 2006-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194335760 | Cho Jeon Yun Dental Partnership | Dentist | 9655 Monte Vista Ave #406, Montclair, CA 91763 | 2020-08-07 |
| 1215498811 | Above Urgent Care Center | Emergency Medicine | 8891 N. Central Ave Ste A, Montclair, CA 91763 | 2019-03-27 |
| 1467936906 | Bronislava Kroulik | Behavior Technician | 4950 San Bernardino St Ste 101, Montclair, CA 91763 | 2018-09-20 |
| 1063936110 | Monique Karina Enriquez | Licensed Vocational Nurse | 5580 Moreno St #82, Montclair, CA 91763 | 2017-07-31 |
| 1972961159 | Lacy Pinsky | Specialist/Technologist | 5035 Flora St., Montclair, CA 91763 | 2016-02-03 |
| 1912333790 | Cinta Hospice Care Inc | Hospice Care, Community Based | 5050 Palo Verde Street, Suite 101, Montclair, CA 91763 | 2013-09-24 |
| 1720334626 | Priority One Hospice, Inc. | Hospice Care, Community Based | 4959 Palo Verde St Ste 107c, Montclair, CA 91763 | 2012-07-28 |
| 1689982498 | Paulina Trujillo Perez | Counselor | 9916 Central Ave., Montclair, CA 91763 | 2010-09-15 |
| 1982846499 | Esther Phillips Agepogu | Physician Assistant | 9301 Central Ave., Montclair, CA 91763 | 2009-03-30 |
| 1568633139 | Mahin Nosrati-jahromi | Dentist | 9509 Central Ave #d, Montclair, CA 91763 | 2008-03-21 |
| Find all providers in zip 91763 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881861086 | Barry Isadore Loigman | Radiology | 116 Park St, Montclair, NJ 07042-2930 | 2008-05-15 |
| 1063582112 | Camiar Ohadi | Radiology | 9655 Montevista Ave Ste 403, Montclair, CA 91763 | 2006-11-08 |
| 1245393974 | Cheng Ow | Radiology | 37 N Fullerton Ave, Montclair, NJ 07042-3426 | 2006-12-17 |
| 1790720811 | Maria Rita Giacomazza | Radiology | 37 N Fullerton Ave, Montclair Breast Center, Montclair, NJ 07042-3426 | 2006-06-20 |
| 1245278845 | Shiv Navani | Radiology | 1 Bay Ave, Radiology Department, Montclair, NJ 07042-4837 | 2006-06-03 |
| 1033166582 | Joo Young Melissa Lee | Radiology | 37 No Fullerton Avenue, Montclair Breast Center, Montclair, NJ 07042-3426 | 2006-05-30 |
| 1053367334 | Montclair Breast Center PC | Radiology | 37 No Fullerton Avenue, Montclair Breast Center PC, Montclair, NJ 07042-3426 | 2006-05-26 |
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| 1558960161 | Antelope Valley Outpatient Imaging Center, LLC | Radiology | 38209 47th St E Ste D, Palmdale, CA 93552-3113 | 2020-10-23 |
| 1003415613 | Antelope Valley Outpatient Imaging Center, LLC | Radiology | 38925 Trade Center Dr Unit E, Palmdale, CA 93551-3655 | 2020-10-23 |
| 1083213151 | Antelope Valley Outpatient Imaging Center, LLC | Radiology | 44105 15th St W Ste 100, Lancaster, CA 93534-4090 | 2020-10-20 |
| 1750980967 | Centrelake Medical Group Inc | Radiology | 430 W Stetson Ave, Hemet, CA 92543-7328 | 2020-10-19 |
| 1538775994 | Richard J. Moran | Radiology | 230 S Main St Ste 101, Orange, CA 92868-3851 | 2020-09-21 |
| 1417567710 | Family Medical Diagnostics Inc | Radiology | 19231 Victory Blvd Ste 356, Reseda, CA 91335-6308 | 2020-08-03 |
| 1396365011 | Prodiagnose Inc | Radiology | 7345 Topanga Canyon Blvd # 210, Canoga Park, CA 91303-1244 | 2020-04-22 |
| 1548892276 | Alvarado Radiology Group Inc, A Professional Corporation | Radiology | 13700 Marina Pointe Dr Unit 430, Marina Del Rey, CA 90292-9277 | 2020-02-11 |
| 1710518535 | Health Diagnostics of California A Professional Corporation | Radiology | 1690 Barton Rd Ste 107, Redlands, CA 92373-4230 | 2020-01-30 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.