| NPI | 1639921299 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY LOU LOPEZ Director Of Billing 559-646-6618 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2024-04-04 |
| Last Update Date | 2024-04-04 |