D Starks MD Incorporated

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

G49823 Issued in CA

Legal business name

D STARKS MD INCORPORATED

Practice address

5153 Holt Blvd
Suite B-2
Montclair, CA 91763-4837

Phone

(909) 625-0661

Fax

(909) 625-7761

NPI assigned

May 12, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. D'Mitri Starks, MD

Title

Ceo

Phone

(909) 625-0661

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1242086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242086400000",
    "number": "1154555795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5153 HOLT BLVD",
            "address_2": "SUITE B-2",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917634837",
            "telephone_number": "909-625-0661",
            "fax_number": "909-625-7761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5153 HOLT BLVD",
            "address_2": "SUITE B-2",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917634837",
            "telephone_number": "909-625-0661",
            "fax_number": "909-625-7761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D STARKS MD INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-12",
        "last_updated": "2009-05-12",
        "status": "A",
        "authorized_official_last_name": "STARKS",
        "authorized_official_first_name": "D'MITRI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-625-0661",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CA",
            "license": "G49823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G498230",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Medical Specialty Clinic/Center in Montclair, CA
• Providers in Montclair, CA by specialty
• Medical Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.