| NPI | 1174913776 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDGAR ALEXANDER CHAVEZ CEO 323-233-3100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A92965) |
| Enumeration Date | 2015-02-03 |
| Last Update Date | 2019-09-03 |