| NPI | 1356864078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DORA L CHAVEZ Office Manager 805-312-9082 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: CA DC27583) |
| Enumeration Date | 2017-07-25 |
| Last Update Date | 2022-07-21 |