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Organization

NORTHEAST COMMUNITY CLINIC

Active
Parent organization
NORTHEAST COMMUNITY CLINIC
Organization subpart
Yes

Provider details

NPI number
Legal business name
NORTHEAST COMMUNITY CLINIC
Authorized official
DR. CHRISTOPHER LAU M.D. (EXECUTIVE DIRECTOR)
(626) 457-6900
Entity
Organization

Contact information

Practice address
5420 N FIGUEROA ST, LOS ANGELES, CA 90042
(323) 256-3884
(323) 258-6307
Mailing address
2550 W MAIN ST, SUITE 301, ALHAMBRA, CA 91801-1694
(626) 457-6900
(626) 457-1233

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
HAP11584G
CA
207V00000X
Obstetrics & Gynecology Physician
HAP11584G
CA
261QF0400X
Federally Qualified Health Center (FQHC)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
HAP11584G
CA
Enumeration date
12/21/2007
Last updated
10/15/2021
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