Northeast Community Clinic | |
1403 Lomita Blvd Ste 103 Harbor City CA 90710-2084 | |
(310) 784-1800 | |
(310) 602-3737 |
Full Name | Northeast Community Clinic |
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Speciality | Clinic/Center |
Location | 1403 Lomita Blvd Ste 103, Harbor City, California |
Authorized Official Name and Position | Christopher Tak Lau (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 6264576900 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Northeast Community Clinic 2550 W Main St Ste 301 Alhambra CA 91801-7003 Ph: (626) 457-6900 | Northeast Community Clinic 1403 Lomita Blvd Ste 103 Harbor City CA 90710-2084 Ph: (310) 784-1800 |
NPI Number | 1043725583 |
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Provider Enumeration Date | 12/06/2017 |
Last Update Date | 10/15/2021 |
Medicare PECOS PAC ID | 5193710275 |
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Medicare Enrollment ID | O20180124000324 |
Identifier | Type | State | Issuer |
---|---|---|---|
1043725583 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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