NPI | 1003546342 |
---|---|
Entity Type | Organization |
Authorized Contact | NICOLIS ARIAS Credentialing 562-690-0400 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2022-06-10 |
Last Update Date | 2022-06-10 |