NPI | 1063438232 |
---|---|
Doing Business As | EASTSIDE NEIGHBORHOOD CLINIC |
Entity Type | Organization |
Authorized Contact | CHARLES CAMILLO FENZI Chief Executive Officer 805-617-7850 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: CA 050000113) |
Enumeration Date | 2006-07-14 |
Last Update Date | 2016-03-03 |