| NPI | 1497008528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETTINA LEWIS COO 213-893-1960 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: CA 960000972) |
| Enumeration Date | 2012-10-26 |
| Last Update Date | 2021-05-07 |