| NPI | 1164087268 |
|---|---|
| Doing Business As | CMC, LODI VINE FAMILY CARE, SUITE 105 |
| Entity Type | Organization |
| Authorized Contact | CHRISTINE NOGUERA CEO 209-373-2831 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2019-05-03 |
| Last Update Date | 2019-07-05 |