| NPI | 1760119309 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOLORES BONILLA Chief Executive Officer 310-549-5760 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2022-08-03 |
| Last Update Date | 2022-08-03 |