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Organization
OUR MISSION MEDICAL CLINIC
Active
Organization
OUR MISSION MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMMA BACANI (CFO)
(626) 807-0401
Entity
Organization
Contact information
Practice address
1811 W KATELLA AVE STE 117, ANAHEIM, CA 92804-6657
(657) 220-4208
(714) 333-4980
Mailing address
1811 W KATELLA AVE STE 117, ANAHEIM, CA 92804-6657
(657) 220-4208
(714) 333-4980
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
09/26/2018
Last updated
08/07/2023
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