| NPI | 1932479243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA M ARCE Billing Manager 310-664-7828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: CA A34595) |
| Enumeration Date | 2012-01-03 |
| Last Update Date | 2012-01-03 |