Mission City Community Network, Inc.

LBN: Mission City Community Network, Inc.
Mission City Community Network, Inc. is an health care organization with primary practice located at 4842 Hollywood Blvd , Hollywood CA 90027-5302. The organization recently has 3 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Community Health, Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC), Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center). Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) is the primary health care specialty. Mission City Community Network, Inc. can be contacted via phone (323) 644-1110, or through Gupta, Nik via phone (818) 895-3100.

Contact Information

Primary practice address
4842 Hollywood Blvd Hollywood CA 90027-5302
Phone: (323) 644-1110
Fax: (323) 644-1171
Website:
Map and Directions
Authorized official contact:
Name: Gupta, Nik
Phone: (818) 895-3100

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Community Health 261QC1500X 960001162 California
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X 960001162 California
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X 960001162 California

Profile Details

NPI number 1710102009
LBN Legal business name Mission City Community Network, Inc.
DBA Doing business as
Authorized official Gupta, Nik
Entity Organization
Organization subpart 1 No
Enumeration date Apr 13th, 2007
Last updated Mar 21st, 2011 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710102009 NPPES
California Other FHC70938F MEDICAL PROVIDER NUMBER
California MEDICAID HAP70436F MEDICAL PROVIDER NUMBER
California Other 551067 MEDICAL PROVIDER NUMBER

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