Organization
WESTSIDE MEDICAL GROUP OF MENDOTA INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDALL G STERN M.D. (MEDICAL DIRECTOR)
(559) 655-1000
Entity
Organization
Contact information
Practice address
450 OLLER ST, SUITE#101, MENDOTA, CA 93640-2313
(559) 655-1000
Mailing address
450 OLLER ST, SUITE#101, MENDOTA, CA 93640-2313
(559) 655-1000
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RHM08916F
—
CA
Enumeration date
01/29/2007
Last updated
09/07/2012
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