| NPI | 1063148856 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROMEO V HERRERA Director Of Compliance 310-407-9331 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2022-07-25 |
| Last Update Date | 2022-07-25 |