Organization
MISSION CITY COMMUNITY NETWORK, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIK GUPTA (CEO)
(818) 895-3100
Entity
Organization
Contact information
Practice address
9808 VENICE BLVD, CULVER CITY, CA 90232-2732
(818) 895-3100
Mailing address
8527 SEPULVEDA BLVD, NORTH HILLS, CA 91343-5824
(818) 895-3100
(818) 893-9464
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
05/24/2016
Last updated
01/05/2018
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