Organization
D STARKS MD INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. D'MITRI STARKS MD (CEO)
(909) 625-0661
Entity
Organization
Contact information
Practice address
5153 HOLT BLVD, SUITE B-2, MONTCLAIR, CA 91763-4837
(909) 625-0661
(909) 625-7761
Mailing address
5153 HOLT BLVD, SUITE B-2, MONTCLAIR, CA 91763-4837
(909) 625-0661
(909) 625-7761
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
G49823
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G498230
—
CA
Enumeration date
05/12/2009
Last updated
05/12/2009
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