NPI | 1285895078 |
---|---|
Other Name | VENICE FAMILY CLINIC - CDP |
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 | 261QC1500X Clinic/Center Community Health (Licence: CA 960000169) |
Enumeration Date | 2008-06-24 |
Last Update Date | 2023-09-11 |