| NPI | 1124758883 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLIS ARIAS Credentialing 562-690-0400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2022-06-15 |
| Last Update Date | 2022-09-30 |