| NPI | 1568656791 |
|---|---|
| Doing Business As | EASTSIDE FAMILY CLINIC |
| Entity Type | Organization |
| Authorized Contact | ENRIQUE J. GONZALEZ President 323-261-4706 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261Q00000X (Licence: CA G74790) |
| Enumeration Date | 2007-08-30 |
| Last Update Date | 2022-03-29 |