| NPI | 1154462422 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY GONG CFO 510-986-6830 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: CA 14000012) |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2020-08-22 |