DR. KENNETH STARR


Address: 107 Nelson St, Arroyo Grande, CA 93420-3318
Phone: 8052421360

DR. KENNETH STARR (NPI# 1861431595) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1861431595
Entity Type Individual
Full Name DR. KENNETH STARR
Credential M.D.
Practice Address 107 Nelson St
Arroyo Grande
CA 93420-3318
Mailing Address 105 S Main St
Templeton
CA 93465-9601
Practice Telephone 8052421360
Mailing Telephone (805) 434-1869
Enumeration Date 2006-06-06
Last Update Date 2018-03-17
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207P00000X Emergency Medicine MD22323O OR Allopathic & Osteopathic Physicians
Y 207RA0401X Internal Medicine
Specialization: Addiction Medicine
A105044 CA Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
CHAMPUS A032 01
CHAMPUS H00866 01
GROUP HEALTH H00866 01
LIPA H00866 01
BCBS 057221014 01
OR 288397 05
WA 8283574 05
CA XPY196669 05

Provider Secondary Practice Location

Address Telephone Number Fax Number
1100 Las Tablas Rd, Templeton, CA 934659704 8054344700

Other Providers KENNETH STARR

NPI Name Taxonomy Address Enumeration
1437274511 Kenneth James Starr Physician Assistant 7324 Southwest Fwy Ste 1550, Houston, TX 77074-2053 2007-03-20

Office Location

Street Address 107 NELSON ST
City ARROYO GRANDE
State CA
Zip Code 93420-3318

Providers in the same location

NPI Name Taxonomy Address Enumeration
1083153829 Kristen Robin Anderson Counselor 107 Nelson St, Arroyo Grande, CA 93420-3318 2017-02-13
1871048769 Tikva Treatment Substance Abuse Rehabilitation Facility 107 Nelson St, Arroyo Grande, CA 93420-3318 2016-08-20
1598195810 Ken Starr Md Wellness Group Counselor 107 Nelson St, Arroyo Grande, CA 93420-3318 2013-11-22
1659715100 Elaine Shaver Power Marriage & Family Therapist 107 Nelson St, Arroyo Grande, CA 93420 2013-04-25
1629117981 Emily Jean Maddox Counselor 107 Nelson St, Arroyo Grande, CA 93420-3318 2007-02-05
1982789186 Kenneth Scott Guess Pharmacist 107 Nelson St, Arroyo Grande, CA 93420-3318 2006-10-26

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1992337174 Element Nutrition Company, LLC Dietitian, Registered 405 E. Branch St. #102, Arroyo Grande, CA 93420 2020-02-06
1861965055 Pacific Central Coast Health Centers Clinic/Center 850 Fair Oaks Ave Ste 310, Arroyo Grande, CA 93420 2019-01-10
1629552815 Leanne Marie Ford Physician Assistant 536 Camino Mercado, Arroyo Grande, CA 93420 2018-09-24
1730662107 Kelli Thompson Hamma Massage Therapist 630 Lancaster Dr, Arroyo Grande, CA 93420 2018-09-12
1063962595 Suzanne Erickson Social Worker 2820 Poquito Place, Arroyo Grande, CA 93420 2016-10-07
1255888459 Anka Behavioral Health, Inc. Community/Behavioral Health 2119 Lopez Dr, Arroyo Grande, CA 93420 2016-09-06
1225585664 Tikva Treatment Substance Abuse Rehabilitation Facility 170 Nelson Street, Suite 102, Arroyo Grande, CA 93420 2016-09-01
1831541986 Tikva Treatment LLC Clinic/Center 621 E Grande Ave, Arroyo Grande, CA 93420 2016-07-12
1255788543 David E. Yocum, M.d., A Medical Corporation Internal Medicine 860 Oak Park Blvd., #204, Arroyo Grande, CA 93420 2016-05-17
1689059800 David Hikaru Lindsey Dentist 203 Station Way, Arroyo Grande, CA 93420 2015-07-29
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Taxonomy Information

Taxonomy Code 207RA0401X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Addiction Medicine

Taxonomy Definition

An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine.
Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: added definition, added source; 7/1/2011: modified source]
- Additional Resources: http://www.osteopathic.org/certification

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1902458540 Medicus Telehealth Inc. Internal Medicine 180 N Rexford Dr, Beverly Hills, CA 90210-5406 2019-07-13
1962978114 Samer Moghaddam Md, Apc Internal Medicine 902 N Grand Ave Ste 201, Santa Ana, CA 92701-4218 2018-10-15
1972009785 William Supplee Internal Medicine 151 Calderon Ave Apt 96, Mountain View, CA 94041-1433 2018-04-02
1245767516 Chemical Dependency Treatment Associates, Inc Internal Medicine 455 University Ave Ste 320, Sacramento, CA 95825-6580 2017-05-17
1568917367 Mjc Hospitalist Group, Inc. Internal Medicine 4615 Lemona Ave, Sherman Oaks, CA 91403-2428 2016-08-22
1073962171 Faried Banimahd Md Inc Internal Medicine 1533 E 4th St Ste 4, Santa Ana, CA 92701-5115 2016-06-09
1467827683 360 Recovery Inc Internal Medicine 23986 Aliso Creek Rd Ste 226, Laguna Niguel, CA 92677-3908 2015-12-14
1841665254 Kpg California, LLC Internal Medicine 9000 W Sunset Blvd Ste 1500, West Hollywood, CA 90069-5815 2015-12-10
1780050278 Craig V. Smith, M.d., A Professional Medical Corporation Internal Medicine 6711 Melrose Ave., Los Angeles, CA 90038 2015-08-19
1730561861 Synergy Lifestyle Center, Inc. Internal Medicine 7910 Downing Ave Ste 200, Bakersfield, CA 93308-5016 2015-06-25
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Competitor

Search similar providers

City ARROYO GRANDE
Zip Code 93420

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Dataset Information

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.

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