| NPI | 1053321182 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL TWEEDELL Deputy Director 951-358-5222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A85780) |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: CA 250000680) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2025-09-11 |