NPI | 1063925717 |
---|---|
Entity Type | Organization |
Authorized Contact | FRANCISCO L CASTILLON Chief Executive Officer 661-630-7050 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 1223G0001X Dentist, General Practice |
Enumeration Date | 2017-11-15 |
Last Update Date | 2024-09-23 |