| L A Star Medical Group, Inc. | |
|
10132 California Ave South Gate CA 90280-6008 | |
| (323) 566-4411 | |
| (323) 566-0390 |
| Full Name | L A Star Medical Group, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 10132 California Ave, South Gate, California |
| Authorized Official Name and Position | Emile Shenouda (PRESIDENT) |
| Authorized Official Contact | 3235664411 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| L A Star Medical Group, Inc. 10132 California Ave South Gate CA 90280-6008 Ph: (323) 566-4411 | L A Star Medical Group, Inc. 10132 California Ave South Gate CA 90280-6008 Ph: (323) 566-4411 |
| NPI Number | 1386025773 |
|---|---|
| Provider Enumeration Date | 06/11/2015 |
| Last Update Date | 06/11/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386025773 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A56273 (California) | Primary |
| 208000000X | Pediatrics | A56273 (California) | Secondary |
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