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 | 2024-10-30 |