| Mission City Community Network, Inc. | |
|
513 E Lime Ave Suite 103 Monrovia CA 91016-2982 | |
| (818) 895-3100 | |
| (818) 893-9464 |
| Full Name | Mission City Community Network, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 513 E Lime Ave, Monrovia, California |
| Authorized Official Name and Position | Nik Gupta (CHIEF EXECUTIVE OFFICER) |
| 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. 15206 Parthenia St North Hills CA 91343-5305 Ph: (818) 895-3100 | Mission City Community Network, Inc. 513 E Lime Ave Suite 103 Monrovia CA 91016-2982 Ph: (818) 895-3100 |
| NPI Number | 1063795250 |
|---|---|
| Provider Enumeration Date | 09/23/2011 |
| Last Update Date | 09/23/2011 |
| Medicare PECOS PAC ID | 1658264684 |
|---|---|
| Medicare Enrollment ID | O20120918000883 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063795250 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 960000465 (California) | Primary |
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