| NPI | 1962845131 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MUHAMMAD JAYVON Executive Director 415-339-8813 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: CA 550000861) |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2016-03-04 |