| NPI | 1669524534 |
|---|---|
| Doing Business As | EASTSIDE COMMUNITY HEALTH CLINIC |
| Entity Type | Organization |
| Authorized Contact | JACK E JOHNS Chief Executive Officer 951-571-2300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: CA 250000756) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 47987) |
| 122300000X Dentist (Licence: CA 40093) | |
| 122300000X Dentist (Licence: CA 27343) | |
| 122300000X Dentist (Licence: CA 58321) | |
| 1223G0001X Dentist, General Practice (Licence: CA 40996) | |
| 1223G0001X Dentist, General Practice (Licence: CA 40734) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 46894) | |
| 207Q00000X Family Medicine (Licence: CA A50693) | |
| 207Q00000X Family Medicine (Licence: CA A86874) | |
| 207Q00000X Family Medicine (Licence: CA 11901) | |
| 207Q00000X Family Medicine (Licence: CA 15571) | |
| 207Q00000X Family Medicine (Licence: CA 11428) | |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2011-09-02 |