Provider Demographics
NPI:1710001326
Name:STARR, RALPH (OD)
Entity Type:Individual
Prefix:DR
First Name:RALPH
Middle Name:
Last Name:STARR
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1338 N MOORPARK RD
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-5224
Mailing Address - Country:US
Mailing Address - Phone:805-495-5510
Mailing Address - Fax:805-373-8570
Practice Address - Street 1:1338 N MOORPARK RD
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-5224
Practice Address - Country:US
Practice Address - Phone:805-495-5510
Practice Address - Fax:805-373-8570
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4811T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist