| NPI | 1023526084 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTALE MINEROS Managed Care Director 323-297-0884 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2018-01-11 |
| Last Update Date | 2021-04-30 |