Organization
CALIFORNIA BAPTIST UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY A SISEMORE (CLINIC DIRECTOR)
(951) 552-8137
Entity
Organization
Contact information
Practice address
2900 ADAMS ST STE C10, RIVERSIDE, CA 92504-7915
(951) 552-8137
Mailing address
2900 ADAMS ST STE C10, RIVERSIDE, CA 92504-7915
(423) 316-2305
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
—
—
Other
Enumeration date
10/12/2011
Last updated
05/21/2020
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