| NPI | 1154015394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY HONG VO EVP 909-749-1835 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2023-06-08 |
| Last Update Date | 2024-03-13 |