Provider Demographics
NPI:1982301230
Name:STARR, SAVANNAH LEAH
Entity type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:LEAH
Last Name:STARR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MEDICAL PLAZA #140
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-1634
Mailing Address - Country:US
Mailing Address - Phone:310-794-7700
Mailing Address - Fax:
Practice Address - Street 1:200 MEDICAL PLAZA #140
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-1634
Practice Address - Country:US
Practice Address - Phone:805-883-8758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-07
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program