Organization
STAR CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TARA YEGANEH (PRACTICE MANAGER)
(623) 271-8666
Entity
Organization
Contact information
Practice address
14155 N 83RD AVE STE 138, PEORIA, AZ 85381-5652
(623) 271-8666
(623) 271-9229
Mailing address
PO BOX 72300, PHOENIX, AZ 85050-1022
(623) 271-8666
(623) 271-8666
Taxonomy
Speciality
Code
Description
License number
State
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
38152
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
335672
—
AZ
Enumeration date
02/02/2018
Last updated
04/27/2025
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