Mission City Community Network, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

License

960001162 Issued in CA

Legal business name

MISSION CITY COMMUNITY NETWORK, INC.

Practice address

2655 W. Olympic Blvd.,
Los Angeles, CA 90006-2810

Phone

(818) 895-3100

Fax

(818) 893-9464

NPI assigned

Mar 10, 2017

Organization subpart

Yes

Parent organization

MISSION CITY COMMUNITY NETWORK INC.As reported in NPPES

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

Authorized official

Name

Nik Gupta

Title

Ceo

Phone

(818) 895-3100

Specialties & licenses 1

Addresses

Other names 1

• Mission City Community Network-Korean Town Other name

Part of

Mission City Community NTWK

Locations

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

{
    "created_epoch": "1489104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489449600000",
    "number": "1992246979",
    "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": "2655 W. OLYMPIC BLVD.,",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900062810",
            "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": "2017-03-10",
        "last_updated": "2017-03-14",
        "status": "A",
        "authorized_official_last_name": "GUPTA",
        "authorized_official_first_name": "NIK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-895-3100"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "960001162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mission City Community Network-Korean Town",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• 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.
• Justin D Misterka, PSYD
• Kyle Mistretta

• Federally Qualified Health Center (FQHC) in Los Angeles, CA
• Providers in Los Angeles, 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 Mar 14, 2017; 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.