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
5800 KING AVE, MAYWOOD, CA 90270-2928
(818) 895-3100
(818) 895-9464
Mailing address
8527 SEPULVEDA BLVD, NORTH HILLS, CA 91343-5824
(818) 895-3100
(818) 221-3539
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
550001797
CA
Other
Enumeration date
07/11/2017
Last updated
06/16/2018
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