| Mission City Community Network, Inc.-la Puente | |
|
1025 Willow Ave La Puente CA 91746-1617 | |
| (818) 895-3100 | |
| (818) 893-9464 |
| Full Name | Mission City Community Network, Inc.-la Puente |
|---|---|
| Speciality | Clinic/Center |
| Location | 1025 Willow Ave, La Puente, California |
| Authorized Official Name and Position | Gloria Lina (COO) |
| 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.-la Puente 15206 Parthenia St North Hills CA 91343-5305 Ph: (818) 895-3100 | Mission City Community Network, Inc.-la Puente 1025 Willow Ave La Puente CA 91746-1617 Ph: (818) 895-3100 |
| NPI Number | 1942694096 |
|---|---|
| Provider Enumeration Date | 03/26/2015 |
| Last Update Date | 06/01/2015 |
| Medicare PECOS PAC ID | 1658264684 |
|---|---|
| Medicare Enrollment ID | O20160428001030 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942694096 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (California) | Primary |
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