| NPI | 1558181792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL TAHERI CEO 310-922-1412 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) | |
| Enumeration Date | 2024-10-14 |
| Last Update Date | 2024-10-14 |