Provider Demographics
NPI:1205270154
Name:ALLSTAR HEALTH PROVIDERS, INC.
Entity type:Organization
Organization Name:ALLSTAR HEALTH PROVIDERS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO/HR DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIA CATHERINE
Authorized Official - Middle Name:KOH
Authorized Official - Last Name:CHUA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-945-9899
Mailing Address - Street 1:5787 LITTLE SHAY DR
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-4593
Mailing Address - Country:US
Mailing Address - Phone:909-945-9899
Mailing Address - Fax:909-945-9799
Practice Address - Street 1:10722 ARROW RTE STE 218
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-4810
Practice Address - Country:US
Practice Address - Phone:909-945-9899
Practice Address - Fax:909-945-9799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-22
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X, 251E00000X, 177F00000X
CA550002526251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No177F00000XOther Service ProvidersLodging
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0700940Medicaid
CA059626OtherCMS CERTIFICATION NUMBER