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1215562913
STATESIDE MEDICAL LLC
CLAREMONT, CA
NPI
1215562913
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Entity Type
Organization
Authorized Contact
TOBY MICLAT
Administrator
714-408-8996
Organization Subpart ?
No
Primary Taxonomy
310400000X Assisted Living Facility
Enumeration Date
2020-03-03
Last Update Date
2020-03-03
Business Address
STATESIDE MEDICAL LLC
380 W BASELINE RD
CLAREMONT, CA 91711-1751
Phone number: 714-408-8996
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Mailing Address
STATESIDE MEDICAL LLC
1920 N INDIAN HILL BLVD
CLAREMONT, CA 91711-2721
Phone number: 714-408-8996
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