| NPI | 1124313804 |
|---|---|
| Former Legal Business Name | CENTROMED CITY BASE CLINIC |
| Entity Type | Organization |
| Authorized Contact | CHUCK WALZEL CFO 210-334-3724 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2011-06-10 |
| Last Update Date | 2012-05-10 |