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Organization

NORTHEAST COMMUNITY CLINIC

Active
Parent organization
NORTHEAST COMMUNITY CLINIC
Other names
Diabetes & Endocrinology Specialty Center
Organization subpart
Yes

Provider details

NPI number
Legal business name
NORTHEAST COMMUNITY CLINIC
Authorized official
MR. CHRISTOPHER TAK LAU MD (EXECUTIVE DIRECTOR)
(626) 457-6900
Entity
Organization

Contact information

Practice address
1414 S GRAND AVE STE 456, LOS ANGELES, CA 90015-3071
(213) 745-6047
(213) 748-9715
Mailing address
2550 W MAIN ST STE 301, ALHAMBRA, CA 91801-7003
(626) 457-6900
(626) 457-5022

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary

Other

Enumeration date
12/06/2017
Last updated
10/15/2021
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