| NPI | 1700282175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONY WEBER CEO 209-385-5551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: CA 662674) |
| Enumeration Date | 2014-11-13 |
| Last Update Date | 2014-11-13 |