| NPI | 1518657659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY HONG VO EVP 909-988-2555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2023-05-11 |
| Last Update Date | 2024-03-13 |