NPI | 1679564066 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHAEL TWEEDELL Deputy Director 951-358-5222 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A51050) |
Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: CA 250000536) |
Enumeration Date | 2005-11-03 |
Last Update Date | 2023-03-07 |