| Mission City Community Network, Inc | |
|
613 S Howard St Corona CA 92879-2254 | |
| (818) 895-3100 | |
| (818) 830-0811 |
| Full Name | Mission City Community Network, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 613 S Howard St, Corona, California |
| Authorized Official Name and Position | Nik Gupta (CEO & PRESIDENT) |
| Authorized Official Contact | 8188953100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mission City Community Network, Inc 613 S Howard St Corona CA 92879-2254 Ph: (818) 895-3100 | Mission City Community Network, Inc 613 S Howard St Corona CA 92879-2254 Ph: (818) 895-3100 |
| NPI Number | 1366010209 |
|---|---|
| Provider Enumeration Date | 06/16/2021 |
| Last Update Date | 06/16/2021 |
| Medicare PECOS PAC ID | 1658264684 |
|---|---|
| Medicare Enrollment ID | O20230524003295 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366010209 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
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