NPI | 1033729983 |
---|---|
Entity Type | Organization |
Authorized Contact | ALVARO PROSPERO BALLESTEROS Chief Executive Officer 323-201-4516 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
Enumeration Date | 2020-08-05 |
Last Update Date | 2020-08-05 |