| Central Star Fsp | |
|
3433 W Shaw Ave Ste 102-103 Fresno CA 93711-3229 | |
| (559) 840-4937 | |
| Not Available |
| Full Name | Central Star Fsp |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3433 W Shaw Ave Ste 102-103, Fresno, California |
| Authorized Official Name and Position | Kent Dunlap (PRESIDENT AND CHIEF EXECUTIVE OFFIC) |
| Authorized Official Contact | 3102216336 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Central Star Fsp 1501 Hughes Way Ste 150 Long Beach CA 90810-1878 Ph: (310) 221-6336 | Central Star Fsp 3433 W Shaw Ave Ste 102-103 Fresno CA 93711-3229 Ph: (559) 840-4937 |
| NPI Number | 1285118588 |
|---|---|
| Provider Enumeration Date | 09/21/2018 |
| Last Update Date | 11/03/2023 |
| Certification Date | 11/03/2023 |
| Medicare PECOS PAC ID | 2466874748 |
|---|---|
| Medicare Enrollment ID | O20200615000479 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285118588 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Weiming David Chu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114189529 PECOS PAC ID: 3072783687 Enrollment ID: I20110908001873 |
| Provider Name | Stephen M Grossman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942220926 PECOS PAC ID: 4183521131 Enrollment ID: I20120314000744 |
| Provider Name | Abdolreza Saadabadi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629207865 PECOS PAC ID: 1850510900 Enrollment ID: I20140922002931 |
| Provider Name | Sukhjit Brar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194037325 PECOS PAC ID: 8729440672 Enrollment ID: I20230809003972 |
| Provider Name | Kevin Jon Ing |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437635950 PECOS PAC ID: 3274913991 Enrollment ID: I20240404003593 |
| Provider Name | Raminder Pal S Cheema |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1477963528 PECOS PAC ID: 4183957392 Enrollment ID: I20240507002929 |
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