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      <TotalRevEtcAuditedFinclStmtAmt>26056944</TotalRevEtcAuditedFinclStmtAmt>
      <RevenueSubtotalAmt>26056944</RevenueSubtotalAmt>
      <TotalRevenuePerForm990Amt>26056944</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>25070050</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesSubtotalAmt>25070050</ExpensesSubtotalAmt>
      <TotalExpensesPerForm990Amt>25070050</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part X : FIN48 Footnote</FormAndLineReferenceDesc>
        <ExplanationTxt>The Organization, pursuant to a determination letter from the Internal Revenue Service, is exempt from Federal and State income taxes under Section 501(c)(3) of the Internal Revenue code and Section 23701(d) of the California Revenue and Taxation Code. The accounting standard on accounting for uncertainty in income taxes addresses the determination of whether tax benefits claimed or expected to be claimed on a tax return should be recorded in the financial statements. Under that guidance, the Organization may recognize the tax benefit from an uncertain tax position only if it is more likely than not that the tax position will be sustained on examination by taxing authorities based on the technical merits of the position. Examples of tax positions include the tax-exempt status of the Organization and various positions related to the potential sources of unrelated business taxable income (UBIT). The tax benefits recognized in the financial statements from such a position are measured based on the largest benefit that has a greater than 50% likelihood of being realized upon ultimate settlement. There were no unrecognized tax benefits identified or recorded as liabilities at December 31, 2018.</ExplanationTxt>
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    <IRS990ScheduleJ documentId="IRS990ScheduleJ" softwareId="18007218" softwareVersionNum="2018v3.1">
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <WrittenEmploymentContractInd>X</WrittenEmploymentContractInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>false</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>false</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>false</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>false</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>false</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>false</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
      <RebuttablePresumptionProcInd>false</RebuttablePresumptionProcInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Cha Thao</PersonNm>
        <TitleTxt>Physician</TitleTxt>
        <BaseCompensationFilingOrgAmt>202688</BaseCompensationFilingOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>29</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>202717</TotalCompensationFilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Gustavo Rosales</PersonNm>
        <TitleTxt>General Practioner</TitleTxt>
        <BaseCompensationFilingOrgAmt>204322</BaseCompensationFilingOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>6389</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>210711</TotalCompensationFilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Jeffrey Moy</PersonNm>
        <TitleTxt>Physician</TitleTxt>
        <BaseCompensationFilingOrgAmt>182257</BaseCompensationFilingOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>5633</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>187890</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Rod Faucett</PersonNm>
        <TitleTxt>Internist</TitleTxt>
        <BaseCompensationFilingOrgAmt>185491</BaseCompensationFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>185491</TotalCompensationFilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Tatyana Bak</PersonNm>
        <TitleTxt>CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>213822</BaseCompensationFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>213822</TotalCompensationFilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Thomas Reda</PersonNm>
        <TitleTxt>physician</TitleTxt>
        <BaseCompensationFilingOrgAmt>178812</BaseCompensationFilingOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>5172</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>183984</TotalCompensationFilingOrgAmt>
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    <IRS990ScheduleM documentId="IRS990ScheduleM" softwareId="18007218" softwareVersionNum="2018v3.1">
      <DrugsAndMedicalSuppliesGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <NoncashContributionsRptF990Amt>677889</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>fmv</MethodOfDeterminingRevenuesTxt>
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      <AnyPropertyThatMustBeHeldInd>false</AnyPropertyThatMustBeHeldInd>
      <ReviewProcessUnusualNCGiftsInd>false</ReviewProcessUnusualNCGiftsInd>
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    <IRS990ScheduleO documentId="IRS990ScheduleO" softwareId="18007218" softwareVersionNum="2018v3.1">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 11b: Form 990 Review Process</FormAndLineReferenceDesc>
        <ExplanationTxt>The Form 990 is presented by the CEO to the full Board of Directors and is approved for filing. The CEO is authorized to sign the form 990 after the approval by the full board of directors.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts</FormAndLineReferenceDesc>
        <ExplanationTxt>Every member of the Board of Directors completes a conflict of interest statement each year. Every employee signs a conflict of interest statement for each pay period.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 15a: Compensation Review &amp; Approval Process - CEO, Top Management</FormAndLineReferenceDesc>
        <ExplanationTxt>The Board of Directors hires CEO and top management of the Organization. The compensation amount is based on prevailing salaries in the area and the experience and qualifications of the employee.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees</FormAndLineReferenceDesc>
        <ExplanationTxt>The Board of Directors hires all officers of the Organization. The compensation amount is based on prevailing salaries in the area and the experience and qualifications of the Officer.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 19: Other Organization Documents Publicly Available</FormAndLineReferenceDesc>
        <ExplanationTxt>Documents are available upon request from the general public.</ExplanationTxt>
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</Return>