| NPI | 1639390339 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIM SORG Director Of It 818-654-3911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2020-12-22 |