| NPI | 1407378458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EARLE CHARLES Chief Information Officer 323-432-5093 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2017-07-12 |
| Last Update Date | 2017-07-12 |