| NPI | 1063438232 |
|---|---|
| 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 |