NPIMap

Organization Active NPI

Northeast Community Clinic

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
National Provider Identifier
1164606414
Registry record updated Oct 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
NORTHEAST COMMUNITY CLINIC
Practice address
5420 N Figueroa St
Los Angeles, CA 90042
Phone
(323) 256-3884
Fax
(323) 258-6307
NPI assigned
Dec 21, 2007
Organization subpart
Yes
Parent organization
NORTHEAST COMMUNITY CLINICAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 15, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Christopher Lau, M.D.
Title
Executive Director
Phone
(626) 457-6900

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X HAP11584G CA
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X HAP11584G CA
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

5420 N Figueroa St
Los Angeles, CA 90042

Mailing address

2550 W Main St
Suite 301
Alhambra, CA 91801-1694
Phone (626) 457-6900

Other identifiers 1

IdentifierTypeStateIssuer
HAP11584GMedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Northeast Community Clinic9 organizations share this tax ID, including this one
Part of
Northeast Community Clinic

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1198195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634256000000",
    "number": "1164606414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 W MAIN ST",
            "address_2": "SUITE 301",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918011694",
            "telephone_number": "626-457-6900",
            "fax_number": "626-457-1233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5420 N FIGUEROA ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90042",
            "telephone_number": "323-256-3884",
            "fax_number": "323-258-6307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST COMMUNITY CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHEAST COMMUNITY CLINIC",
        "enumeration_date": "2007-12-21",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A",
        "authorized_official_last_name": "LAU",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "626-457-6900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "HAP11584G",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "HAP11584G",
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HAP11584G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.