| NPI | 1790905594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONY WEBER CEO 209-385-5462 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 040000513) |
| 207R00000X Internal Medicine (Licence: CA 040000513) | |
| 363AM0700X Physician Assistant, Medical (Licence: CA 040000513) | |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 040000513) | |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2021-03-11 |