| NPI | 1639398704 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FEN-LIEN JUANG Credentialing 626-427-9598 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QC1500X Clinic/Center, Community Health | |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2023-06-07 |