| Valley Star Community Services | |
|
1585 South D Street Suite 101, 205 San Bernardino CA 92408-3257 | |
| (909) 388-2222 | |
| Not Available |
| Full Name | Valley Star Community Services |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1585 South D Street, San Bernardino, 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 |
|---|---|
| Valley Star Community Services 1585 South D Street Suite 101, 205 San Bernardino CA 92408-3257 Ph: (909) 388-2222 | Valley Star Community Services 1585 South D Street Suite 101, 205 San Bernardino CA 92408-3257 Ph: (909) 388-2222 |
| NPI Number | 1033269543 |
|---|---|
| Provider Enumeration Date | 01/10/2007 |
| Last Update Date | 02/08/2017 |
| Medicare PECOS PAC ID | 8628479441 |
|---|---|
| Medicare Enrollment ID | O20210630000796 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033269543 | NPI | - | NPPES |
| 204511 | Other | CA | CITY OF S.B. BIZ LIC. |
| 36CL | Other | CA | SAN BERNARDINO CTY PROV # |
| 2403428 | Other | CA | STATE CORP. # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (California) | Primary |
| Provider Name | Weiming David Chu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114189529 PECOS PAC ID: 3072783687 Enrollment ID: I20110908001873 |
| Provider Name | Kevin Jon Ing |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437635950 PECOS PAC ID: 3274913991 Enrollment ID: I20240404003593 |
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