| Mission City Community Network Inc. | |
|
1204 S Central Ave Glendale CA 91204-2504 | |
| (818) 895-3100 | |
| (818) 830-0811 |
| Full Name | Mission City Community Network Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1204 S Central Ave, Glendale, 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. 8527 Sepulveda Blvd North Hills CA 91343-5824 Ph: (818) 895-3100 | Mission City Community Network Inc. 1204 S Central Ave Glendale CA 91204-2504 Ph: (818) 895-3100 |
| NPI Number | 1639878143 |
|---|---|
| Provider Enumeration Date | 02/23/2023 |
| Last Update Date | 02/23/2023 |
| Medicare PECOS PAC ID | 1658264684 |
|---|---|
| Medicare Enrollment ID | O20240105000904 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639878143 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
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