Mission City Community Network, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

License

550001476 Issued in CA

Legal business name

MISSION CITY COMMUNITY NETWORK, INC.

Practice address

222 W Eulalia St Ste 301
Glendale, CA 91204-2851

Phone

(818) 895-3100

Fax

(818) 893-9464

NPI assigned

Dec 5, 2017

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

President/Ceo

Phone

(818) 895-3100

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• MISSION CITY COMMUNITY NETWORK, INC.-GLENDALE Other name

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

{
    "created_epoch": "1512432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1780199307",
    "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": "222 W EULALIA ST STE 301",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042851",
            "telephone_number": "818-895-3100",
            "fax_number": "818-893-9464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION CITY COMMUNITY NETWORK, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-05",
        "last_updated": "2018-06-16",
        "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": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "550001476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "550001476",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MISSION CITY COMMUNITY NETWORK, INC.-GLENDALE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Rita Misakyan, NP
• Michael Misetich
• Christelle Miskinian
• Missagh Pezeshkian, D.D. S., a Professional Corporation
• Mission City Community Network Inc.
• Mission Home Care Services Inc
• Mission Pharmacy and Medical Supplies Inc.
• Raffi Vartan Missirian
• Clinton Aaron Mitchell, PA-C
• Johnny Lee Mitchell Jr., LCSW

• Federally Qualified Health Center (FQHC) in Glendale, CA
• Providers in Glendale, 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 16, 2018; 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.