Starr, Kenneth

Starr, Kenneth is an individual health care provider with primary practice located at 107 Nelson St , Arroyo Grande CA 93420-3318. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Addiction Medicine. Allopathic & Osteopathic Physicians / Addiction Medicine is his primary health care specialty. Starr, Kenneth can be contacted via phone (805) 242-1360.

Contact Information

Primary practice address
107 Nelson St Arroyo Grande CA 93420-3318
Phone: (805) 242-1360
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X MD22323O Oregon
Allopathic & Osteopathic Physicians / Addiction Medicine 207RA0401X A105044 California

Profile Details

NPI number 1861431595
LBN Legal business name Starr, Kenneth
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 6th, 2006
Last updated Jul 21st, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861431595 NPPES
Other H00866 CHAMPUS
Other H00866 CHAMPUS
MEDICAID 8283574 CHAMPUS
MEDICAID XPY196669 CHAMPUS
Other H00866 CHAMPUS
Other 057221014 CHAMPUS
MEDICAID 288397 CHAMPUS
Other A032 CHAMPUS

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