| NPI | 1114901121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONY WEBER CEO 209-384-6493 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: CA 040000550) |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2017-02-09 |