NPI | 1346726940 |
---|---|
Entity Type | Organization |
Authorized Contact | GENEVIEVE MEDINA Credentialing Manager 209-384-6493 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2018-07-17 |
Last Update Date | 2018-07-17 |