| NPI | 1841476553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICARDO ROMAN CFO 619-515-2300 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2008-01-11 |
| Last Update Date | 2024-02-19 |