| NPI | 1912727439 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALVARO PROSPERO BALLESTEROS Chief Executive Officer 323-201-4516 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2024-10-10 |
| Last Update Date | 2025-08-04 |