| NPI | 1194502443 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOLORES BONILLA CEO 310-549-5760 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QC1500X Clinic/Center, Community Health | |
| Enumeration Date | 2023-09-11 |
| Last Update Date | 2023-09-11 |