| Mission City Community Network Inc | |
|
5800 King Ave Maywood CA 90270-2928 | |
| (818) 895-3100 | |
| (818) 895-9464 |
| Full Name | Mission City Community Network Inc |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 5800 King Ave, Maywood, California |
| Authorized Official Name and Position | Nik Gupta (CHIEF EXECUTIVE OFFICER) |
| 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 5800 King Ave Maywood CA 90270-2928 Ph: (818) 895-3100 |
| NPI Number | 1598287682 |
|---|---|
| Provider Enumeration Date | 07/11/2017 |
| Last Update Date | 06/16/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598287682 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 550001797 (California) | Primary |
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