| NPI | 1083651152 |
|---|---|
| Doing Business As | MEDICAL MOBILE UNIT-SLS |
| Entity Type | Organization |
| Authorized Contact | ALFONSO F BANUELOS Chief Medical Officer 408-885-4001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2020-08-22 |