Goldstar Pediatrics Pc

LBN: Goldstar Pediatrics Pc
Goldstar Pediatrics Pc is an health care organization with primary practice located at 15290 Summit Ave Suite B, Fontana CA 92336-0240. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as the primary health care specialty. Goldstar Pediatrics Pc can be contacted via phone (909) 225-1900, or through Tackie, Irmgard Una via phone (909) 225-1900.

Contact Information

Primary practice address
15290 Summit Ave Suite B Fontana CA 92336-0240
Phone: (909) 225-1900
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Tackie, Irmgard Una Doctor of Medicine (MD)
Phone: (909) 225-1900

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X FNP544821 California

Profile Details

NPI number 1427420009
LBN Legal business name Goldstar Pediatrics Pc
DBA Doing business as
Authorized official Tackie, Irmgard Una Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 22nd, 2015
Last updated Dec 23rd, 2021 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427420009 NPPES
California MEDICAID 4685141

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