| NPI | 1548381262 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN F. PETTUS CEO 510-835-9610 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2017-05-17 |