NPI | 1699520809 |
---|---|
Entity Type | Organization |
Authorized Contact | SERGEY P SERGEYEV CEO 949-866-3600 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2024-04-22 |
Last Update Date | 2024-04-22 |