NPI | 1356763155 |
---|---|
Entity Type | Organization |
Authorized Contact | AVETIK MACHKALYAN Chief Executive Officer 909-623-3600 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
Enumeration Date | 2014-01-13 |
Last Update Date | 2020-01-21 |