| NPI | 1013952597 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICARDO ROMAN CFO 619-515-2300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: CA 550000024) |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2024-02-20 |