| Mission City Community Network, Inc. | |
|
1818 N Orange Grove Ave 205 Pomona CA 91767-3028 | |
| (818) 895-3100 | |
| (818) 892-4651 |
| Full Name | Mission City Community Network, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1818 N Orange Grove Ave, Pomona, 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. 1818 N Orange Grove Ave 205 Pomona CA 91767-3028 Ph: (818) 895-3100 |
| NPI Number | 1609151273 |
|---|---|
| Provider Enumeration Date | 10/14/2011 |
| Last Update Date | 10/14/2011 |
| Medicare PECOS PAC ID | 1658264684 |
|---|---|
| Medicare Enrollment ID | O20150527002325 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609151273 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 960000465 (California) | Primary |
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