| NPI | 1902515737 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL PETERSEN CFO 760-736-8699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2022-11-21 |
| Last Update Date | 2025-08-12 |