Mission City Community Network, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

License

550000351 Issued in CA

Legal business name

MISSION CITY COMMUNITY NETWORK, INC.

Practice address

8363 Reseda Blvd Ste 11
Northridge, CA 91324-4694

Phone

(818) 998-7085

Fax

(818) 998-3579

NPI assigned

Oct 31, 2008

Last updated

Jun 6, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Nik Gupta

Title

Cheif Executive Officer

Phone

(818) 895-3100

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1225411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559779200000",
    "number": "1275786402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8527 SEPULVEDA BLVD",
            "city": "NORTH HILLS",
            "state": "CA",
            "postal_code": "913435824",
            "telephone_number": "818-895-3100",
            "fax_number": "818-892-3352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8363 RESEDA BLVD STE 11",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913244694",
            "telephone_number": "818-998-7085",
            "fax_number": "818-998-3579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION CITY COMMUNITY NETWORK, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-31",
        "last_updated": "2019-06-06",
        "status": "A",
        "authorized_official_last_name": "GUPTA",
        "authorized_official_first_name": "NIK",
        "authorized_official_title_or_position": "CHEIF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "818-895-3100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "550000351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL PROVIDER NUMBER",
            "identifier": "HAP70436F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL PROVIDER NUMBER",
            "identifier": "EAP70436F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL PROVIDER NUMBER",
            "identifier": "FHC70436F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Darrel Martin Miranda
• Haydee Miranda
• Luz Liliana Miranda, MSW
• Inessa Miretsky, PHARM.D.
• Howard Leonard Misheloff, O.D.
• Mission Hills Pain Management Medical Corporation
• Valeria Mitjans Morales
• MK Jefferson MD Anesthesia Servics, Inc.
• Nune Mkheyan, DDS
• MM Good Care Hospice Inc

• Federally Qualified Health Center (FQHC) in Northridge, CA
• Providers in Northridge, CA by specialty
• Federally Qualified Health Center (FQHC) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2019; 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.