| NPI | 1457621922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE RENEE BAGALAYOS Director Of Finance 209-373-2838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: CA 550000238) |
| Enumeration Date | 2011-12-30 |
| Last Update Date | 2011-12-30 |