| NPI | 1912189424 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALVARO P. BALLESTEROS Chief Executive Officer 213-484-1186 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: CA 960000791) |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health (Licence: CA 960001445) |
| 261QC1500X Clinic/Center, Community Health (Licence: CA 550000250) | |
| 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: CA 950001280) | |
| 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: CA 550000019) | |
| 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: CA 960000919) | |
| Enumeration Date | 2007-11-27 |
| Last Update Date | 2007-11-27 |