| Northeast Community Clinic | |
|
4455 W 117th St Ste 300 Hawthorne CA 90250-2240 | |
| (310) 645-0444 | |
| (310) 978-0599 |
| Full Name | Northeast Community Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 4455 W 117th St Ste 300, Hawthorne, 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 |
|---|---|
| Northeast Community Clinic 2550 W Main St Suite 301 Alhambra CA 91801-1694 Ph: (626) 457-6900 | Northeast Community Clinic 4455 W 117th St Ste 300 Hawthorne CA 90250-2240 Ph: (310) 645-0444 |
| NPI Number | 1891028171 |
|---|---|
| Provider Enumeration Date | 09/17/2009 |
| Last Update Date | 10/15/2021 |
| Medicare PECOS PAC ID | 5193710275 |
|---|---|
| Medicare Enrollment ID | O20111117000738 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891028171 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Keith Ebilane, M.d., Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 13429 Hawthorne Blvd, Hawthorne, CA 90250 Phone: 310-644-8683 Fax: 310-644-0132 | |
Behavioral Health Services, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 12954 Hawthorne Blvd Ste 100, Hawthorne, CA 90250 Phone: 310-978-6900 Fax: 310-218-5484 | |
Ace Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4477 W 118th St, Suite 200, Hawthorne, CA 90250 Phone: 310-675-4440 Fax: 310-675-5816 | |
Ananias E. Ebilane, M.d., Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 13429 S Hawthorne Blvd, Hawthorne, CA 90250 Phone: 310-644-8683 Fax: 310-644-0132 | |
St.anthony Medical Centers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 13865 Hawthorne Blvd, Hawthorne, CA 90250 Phone: 310-331-0555 Fax: 310-759-0555 | |
Lieu S. Nguyen, M.d., A Professional Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 15032 Prairie Ave, Hawthorne, CA 90250 Phone: 310-675-7343 Fax: 310-675-1951 | |
Mehmet C Demirozu M D Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4477 W 118th St, Suite 303, Hawthorne, CA 90250 Phone: 310-644-9515 Fax: 310-644-3629 |