| NPI | 1184297681 |
|---|---|
| Other Name | VENICE SOUTH BAY GARDENA |
| Entity Type | Organization |
| Authorized Contact | MITESH G POPAT Chief Executive Officer 310-664-7901 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2021-07-21 |
| Last Update Date | 2023-11-30 |