| NPI | 1447836267 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM BRIAN WALLACE VP/CFO 619-205-6339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2021-03-22 |
| Last Update Date | 2021-03-22 |