Organization
NORTHEAST COMMUNITY CLINIC
Active
Parent organization
NORTHEAST COMMUNITY CLINIC
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTHEAST COMMUNITY CLINIC
Authorized official
CHRISTOPHER TAK LAU MD (EXECUTIVE DIRECTOR)
(626) 457-6900
Entity
Organization
Contact information
Practice address
5428 N FIGUEROA ST, LOS ANGELES, CA 90042-4118
(323) 256-3884
(323) 258-6307
Mailing address
2550 W MAIN ST, SUITE 301, ALHAMBRA, CA 91801-1694
(626) 457-6900
(626) 457-5022
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
BCP11584G
—
CA
Enumeration date
12/11/2007
Last updated
10/15/2021
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