NPI 1215562913

Stateside Medical LLC

Organisation Assisted Living Facility Claremont, CA

Practice location

Address: 380 W Baseline Rd, Claremont, CA 91711-1751
Phone: (714) 408-8996
Mailing address: 1920 N Indian Hill Blvd, Claremont, CA 91711-2721

Authorised official

Name: Toby Miclat
Title: Administrator
Phone: (714) 408-8996

Registered specialties

Assisted Living Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310400000X

Other Assisted Living Facility providers in California →

Registry record

NPI: 1215562913
Entity type: Organization
NPI issued: 3 Mar 2020
Record last updated: 3 Mar 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.