STARSHIP MEDICAL CORPORATION NPI 1902490600

NPI Information

NPI: 1902490600
Provider Name: STARSHIP MEDICAL CORPORATION
Classification: Preventive Medicine - 2083S0010X
Entity Type: Organization

Specialization: Sports Medicine

Address:
1703 N AVALON BLVD
WILMINGTON, CA
ZIP 90744
Phone: (310) 233-9355
Get Directions

STARSHIP MEDICAL CORPORATION is a sports medicine preventive medicine in Wilmington, CA. The provider is a preventive medicine physician who specializes in the diagnosis and treatment of sports related conditions and injuries. STARSHIP MEDICAL CORPORATION NPI is 1902490600. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1703 N AVALON BLVD
WILMINGTON, CA
ZIP 90744-432
Phone: (310) 233-9355
Fax: (310) 233-2545

The provider's authorized official is Eddie Santiago .
The authorized official title is Administrator and has the following contact phone number (818) 610-9360.

The enumeration date for this NPI number is 2/23/2021 and was last updated on 5/19/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	104100000X	Social Worker		No
2	111NN1001X	Chiropractor	Nutrition	No
3	133V00000X	Dietitian, Registered		No
4	207K00000X	Allergy & Immunology		No
5	2083S0010X	Preventive Medicine	Sports Medicine	Yes
6	208D00000X	General Practice		No
7	363A00000X	Physician Assistant		No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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