| NPI | 1093095192 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS TWEH CEO 323-776-1500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2011-08-19 |
| Last Update Date | 2021-03-22 |