| NPI | 1427043389 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIM SORG Director Of Information Technology 818-654-3911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| 3336C0002X Pharmacy, Clinic Pharmacy | |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2020-12-22 |