Active NPI
Mission City Community Network Inc
- Clinic/Center
- Los Angeles, CA
National Provider Identifier
1548740939
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- License
- 550001476
- Legal business name
- MISSION CITY COMMUNITY NETWORK INC
- Practice address
- 5300 Santa Monica Blvd Ste 202
Los Angeles, CA 90029 - Phone
- (818) 895-3100
- Fax
- (818) 893-9464
- NPI assigned
- Aug 15, 2018
- Organization subpart
- Yes
- Parent organization
- MISSION CITY COMMUNITY NETWORK, INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Nik Gupta
- Title
- President/Ceo
- Phone
- (818) 895-3100
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | 550001476 | CA | Primary |
Addresses
Primary practice location
5300 Santa Monica Blvd Ste 202
Los Angeles, CA 90029
Mailing address
8527 Sepulveda Blvd
North Hills, CA 91343-5824
Phone (818) 895-3100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Federally qualified health center certification: CCN 921834
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- MISSION CITY COMMUNITY NETWORK, INC. -SANTA MONICA
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Jan 12, 2020
- Last certification
- Jan 12, 2020
- Ownership / control type
- For profit – corporation
- Facility address
- 5300 Santa Monica Blvd, Suite 202
Los Angeles, CA 90029
National Provider Directory
National Provider Directory- Part of
- Mission City Community NTWK
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534291200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1581465600000",
"number": "1548740939",
"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": "818-893-9464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5300 SANTA MONICA BLVD STE 202",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90029",
"telephone_number": "818-895-3100",
"fax_number": "818-893-9464"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MISSION CITY COMMUNITY NETWORK INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "MISSION CITY COMMUNITY NETWORK, INC.",
"enumeration_date": "2018-08-15",
"last_updated": "2020-02-12",
"certification_date": "2020-02-12",
"status": "A",
"authorized_official_last_name": "GUPTA",
"authorized_official_first_name": "NIK",
"authorized_official_title_or_position": "PRESIDENT/CEO",
"authorized_official_telephone_number": "818-895-3100",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": "CA",
"license": "550001476",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
- Bahareh Missaghi, DC
- Missak Kltchian MD Inc.
- Mary Guinevere Missig, AMFT
- Mission Behavioral Health, Inc.
- Mission City Community Network Inc
- Mission City Community Network, Inc.
- Mission City Community Network, Inc.
- Mission Home Health Service, Inc.
- Mission Home Health Services, Inc
- Mission of Mercy Hospice, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2020; 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.