| NPI | 1164703484 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALVARO BALLESTEROS CEO 213-484-1186 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) (Licence: CA 550000019) |
| Additional Taxonomies | 261QC1500X Clinic/Center Community Health |
| Enumeration Date | 2011-08-31 |
| Last Update Date | 2013-10-24 |