| NPI | 1013444660 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD LEW Chief Dentist 213-808-1790 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: CA 960000220) |
| Enumeration Date | 2017-05-15 |
| Last Update Date | 2022-02-11 |