Mission City Community Network, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

License

960000465 Issued in CA

Legal business name

MISSION CITY COMMUNITY NETWORK, INC.

Practice address

14850 Roscoe Blvd
Panorama City, CA 91402-4618

Phone

(818) 895-3100

Fax

(818) 892-4651

NPI assigned

Sep 16, 2010

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

C.E.O

Phone

(818) 895-3100

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Federally qualified health center certification: CCN 551066

Legal name

MISSION CITY COMMUNITY NETWORK INC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Oct 28, 2010

Last certification

Oct 28, 2010

Ownership / control type

For profit – corporation

Facility address

14850 Roscoe Street
Panorama City, CA 91402

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

{
    "created_epoch": "1284595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284595200000",
    "number": "1467760165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15206 PARTHENIA ST",
            "city": "NORTH HILLS",
            "state": "CA",
            "postal_code": "913435305",
            "telephone_number": "818-895-3100",
            "fax_number": "818-892-4651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14850 ROSCOE BLVD",
            "city": "PANORAMA CITY",
            "state": "CA",
            "postal_code": "914024618",
            "telephone_number": "818-895-3100",
            "fax_number": "818-892-4651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION CITY COMMUNITY NETWORK, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-16",
        "last_updated": "2010-09-16",
        "status": "A",
        "authorized_official_last_name": "GUPTA",
        "authorized_official_first_name": "NIK",
        "authorized_official_title_or_position": "C.E.O",
        "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": "960000465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lorraine N. Minobe, MD
• David Mirinjian
• Asher Benjamin Mirvish, MD
• Arshia Mirzadeh, PA
• Linet Mirzaian, MD
• Mission City Community Network,Inc.
• Mission Community Hospital
• Mission Community Pharmacy Inc.
• Mission Health Care Providers, Inc.
• Rita Miwalian

• Federally Qualified Health Center (FQHC) in Panorama City, CA
• Providers in Panorama City, 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 Sep 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.