NPI | 1558934059 |
---|---|
Other Name | VENICE SOUTH BAY INGLEWOOD |
Entity Type | Organization |
Authorized Contact | MITESH G POPAT Chief Executive Officer 310-664-7901 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
Enumeration Date | 2021-07-21 |
Last Update Date | 2023-11-30 |