Organization · Type 2 NPI

State of California - Department of Developmental Services

Federally Qualified Health Center (FQHC) · Pomona, CA

NPI number 1093085565 Active

Practice location

3530 W Pomona Blvd
Pomona, CA 91768-3238

Call (909) 444-7000 Map

Mailing address

1600 9th St Ste 205, Ms 2-3
Sacramento, CA 95814-6435

Specialties and licenses

TaxonomyCodeLicense
Federally Qualified Health Center (FQHC) Primary 261QF0400XNone listed

Federally Qualified Health Center (FQHC): Definition to come...

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About NPI 1093085565

State of California - Department of Developmental Services's National Provider Identifier is 1093085565, issued on Dec 30, 2011. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Pomona, CA. The record was last updated on Jan 17, 2012.