Provider Demographics
NPI:1851064760
Name:SO CAL IN HOME, INC.
Entity Type:Organization
Organization Name:SO CAL IN HOME, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:S
Authorized Official - Last Name:CLAMOR
Authorized Official - Suffix:
Authorized Official - Credentials:DOM, LAC
Authorized Official - Phone:909-272-4950
Mailing Address - Street 1:328 W E ST
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91762-3422
Mailing Address - Country:US
Mailing Address - Phone:909-272-4950
Mailing Address - Fax:
Practice Address - Street 1:328 W E ST
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91762-3422
Practice Address - Country:US
Practice Address - Phone:909-272-4950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-27
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care