| NPI | 1417409228 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICARDO ROMAN CFO 619-515-2300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2016-10-27 |
| Last Update Date | 2024-02-20 |