Provider Demographics
NPI:1245603109
Name:CALSTRO HOSPICE INC.
Entity Type:Organization
Organization Name:CALSTRO HOSPICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:
Authorized Official - Last Name:CALDERA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:909-399-0700
Mailing Address - Street 1:4959 PALO VERDE ST
Mailing Address - Street 2:SUITE 206 C-2
Mailing Address - City:MONTCLAIR
Mailing Address - State:CA
Mailing Address - Zip Code:91763-2331
Mailing Address - Country:US
Mailing Address - Phone:909-399-0700
Mailing Address - Fax:909-399-0733
Practice Address - Street 1:4959 PALO VERDE ST
Practice Address - Street 2:SUITE 206 C2
Practice Address - City:MONTCLAIR
Practice Address - State:CA
Practice Address - Zip Code:91763-2331
Practice Address - Country:US
Practice Address - Phone:909-399-0700
Practice Address - Fax:909-399-0733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-02
Last Update Date:2015-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based