Organization
MISSION COMMUNITY IPA MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LINDA DEAKTOR RN (DIRECTOR OF MEDICAL AFFAIRS)
(818) 702-0100
Entity
Organization
Contact information
Practice address
6400 CANOGA AVE, SUITE 163, WOODLAND HILLS, CA 91367-2425
(818) 702-0100
(818) 702-9128
Mailing address
PO BOX 571270, TARZANA, CA 91357-1270
(818) 702-0100
(818) 702-9128
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
03/13/2007
Last updated
08/22/2020
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