Organization
MISSION CITY COMMUNITY NETWORK, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIK GUPTA (CHIEF EXECUTIVE OFFICER)
(818) 895-3100
Entity
Organization
Contact information
Practice address
301 N PRAIRIE AVE, 311, INGLEWOOD, CA 90301-4507
(818) 895-3100
(818) 892-4651
Mailing address
15206 PARTHENIA ST, NORTH HILLS, CA 91343-5305
(818) 895-3100
(818) 892-4651
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
960000465
CA
Other
Enumeration date
10/14/2011
Last updated
10/14/2011
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