Organization
MISSION CITY COMMUNITY NETWORK, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NIK GUPTA (C.E.O)
(818) 895-3100
Entity
Organization
Contact information
Practice address
14850 ROSCOE BLVD, PANORAMA CITY, CA 91402-4618
(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
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
960000465
CA
Other
Enumeration date
09/16/2010
Last updated
09/16/2010
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