| NPI | 1861603151 |
|---|---|
| Doing Business As | 25TH STREET FAMILY MEDICINE |
| Entity Type | Organization |
| Authorized Contact | JUDITH SHAPLIN CEO 619-445-6200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: CA 550000543) |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2017-05-08 |