| NPI | 1063493054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL TWEEDELL Deputy Director 951-358-5222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: CA 250000542) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA a82578) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2025-09-11 |