| NPI | 1457229197 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN LONG Credentialing Manager 213-479-9492 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2025-10-24 |
| Last Update Date | 2025-10-24 |