| NPI | 1487639027 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONY WEBER CEO 209-384-6493 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: CA 040000513) |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2020-10-12 |