| NPI | 1487345518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY HONG VO Executive Vice President 909-749-1835 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2023-05-18 |
| Last Update Date | 2023-05-18 |