NPI | 1699465732 |
---|---|
Entity Type | Organization |
Authorized Contact | KELLY HONG VO EVP 909-988-2555 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2023-05-11 |
Last Update Date | 2024-03-13 |