| NPI | 1720178478 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM THOMSEN CEO 951-864-1097 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: CA 250000055) |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: CA 240000751) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2021-08-24 |