| NPI | 1013231646 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID MODERSBACH Program Director 510-532-1930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 251K00000X Public Health or Welfare |
| Enumeration Date | 2010-03-25 |
| Last Update Date | 2013-11-05 |