| Mission City Community Network, Inc. | |
|
9808 Venice Blvd Culver City CA 90232-2732 | |
| (818) 895-3100 | |
| Not Available |
| Full Name | Mission City Community Network, Inc. |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 9808 Venice Blvd, Culver City, California |
| Authorized Official Name and Position | Nik Gupta (CEO) |
| Authorized Official Contact | 8188953100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mission City Community Network, Inc. 8527 Sepulveda Blvd North Hills CA 91343-5824 Ph: (818) 895-3100 | Mission City Community Network, Inc. 9808 Venice Blvd Culver City CA 90232-2732 Ph: (818) 895-3100 |
| NPI Number | 1528416104 |
|---|---|
| Provider Enumeration Date | 05/24/2016 |
| Last Update Date | 01/05/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528416104 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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