| NPI | 1235283094 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARICELA MENDOZA Managed Care Lead 323-724-0019 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2022-12-21 |