NORTHEAST COMMUNITY CLINIC (NPI# 1336790914) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336790914 |
| Entity Type | Organization |
| Organization Name | NORTHEAST COMMUNITY CLINIC |
| Practice Address |
4455 W 117th St Ste 502 Hawthorne CA 90250-2261 |
| Mailing Address |
2550 W Main St Ste 301 Alhambra CA 91801-7003 |
| Practice Telephone | 4242364800 |
| Practice Fax Number | 4242364801 |
| Mailing Telephone | 6264576900 |
| Mailing Fax Number | 6264575022 |
| Enumeration Date | 2019-09-24 |
| Last Update Date | 2019-09-24 |
| Authorized Official Name | CHRISTOPHER TAK LAU (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6264576900 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437792447 | Northeast Community Clinic | Family Medicine | 1414 S Grand Ave Ste 300, Los Angeles, CA 90015-3072 | 2019-10-22 |
| 1972786051 | Northeast Community Clinic | Family Medicine | 5428 N Figueroa St, Los Angeles, CA 90042-4118 | 2007-12-11 |
| 1851942288 | Northeast Community Clinic | Pediatrics | 1414 S Grand Ave Ste 200, Los Angeles, CA 90015-3072 | 2019-09-26 |
| 1801447958 | Northeast Community Clinic | Physician Assistant | 5420 N Figueroa St, Los Angeles, CA 90042-4118 | 2019-09-20 |
| 1962050120 | Northeast Community Clinic | Internal Medicine | 4455 W 117th St Ste 200, Hawthorne, CA 90250-2240 | 2019-08-30 |
| 1366957508 | Northeast Community Clinic | Internal Medicine | 4129 Gage Ave, Bell, CA 90201-1128 | 2017-12-11 |
| 1275048415 | Northeast Community Clinic | Obstetrics & Gynecology | 5820 N Figueroa St, Los Angeles, CA 90042-4228 | 2017-12-11 |
| 1063927564 | Northeast Community Clinic | Internal Medicine | 1414 S Grand Ave Ste 456, Los Angeles, CA 90015-3071 | 2017-12-06 |
| 1043725583 | Northeast Community Clinic | Pediatrics | 1403 Lomita Blvd Ste 103, Harbor City, CA 90710-2084 | 2017-12-06 |
| 1891200325 | Northeast Community Clinic | Family Medicine | 1414 S Grand Ave Ste 380, Los Angeles, CA 90015-3072 | 2017-12-06 |
| Street Address |
4455 W 117TH ST STE 502 |
| City | HAWTHORNE |
| State | CA |
| Zip Code | 90250-2261 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508479627 | Alexis Lemmon | Dental Hygienist | 13450 Hawthrone Blvd, Hawthorne, CA 90250 | 2020-08-28 |
| 1336620459 | Lan Ngoc Ton | Dentist | 13450 S. Hawthorne Blvd, Hawthorne, CA 90250 | 2018-08-27 |
| 1356829261 | Karneth Health Inc | Internal Medicine | 4512 W. Imperial Hwy, Ste B, Hawthorne, CA 90250 | 2018-08-02 |
| 1225524663 | Viridian Healthcare LLC | In Home Supportive Care | 13658 Hawthorne Blvd Ste 201, Hawthorne, CA 90250 | 2018-07-09 |
| 1235636044 | Sonia Medical Center Inc | Clinic/Center | 4512 W Imperial Hwy, Hawthorne, CA 90250 | 2018-04-09 |
| 1518484807 | Jessica Anne-marie Auzenne-harris | Nurse Practitioner | 12618 Hawthorne Blvd, Hawthorne, CA 90250 | 2017-08-28 |
| 1669993358 | Ololade Olamide Obafemi | Nurse Practitioner | 12954 Hawthorne Boulevard, Suite 104, Hawthorne Morningside Medical Clinic, Hawthorne, CA 90250 | 2017-07-03 |
| 1588194534 | Marissam Medical Inc. | Durable Medical Equipment & Medical Supplies | 13508 Inglewood Ave, Hawthorne, CA 90250 | 2017-06-13 |
| 1043751886 | Ogbonna Iwuamadi Olelewe | Nurse Practitioner | 11712 S. Hawthorne Blvd, Hawthorne, CA 90250 | 2017-03-13 |
| 1952758898 | La Shada Kai Martin | Contractor | 13010 Kornblum Ave, Unit D, Hawthorne, CA 90250 | 2016-05-20 |
| Find all providers in zip 90250 | ||||
| Taxonomy Code | 207RE0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Endocrinology, Diabetes & Metabolism |
| An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649613761 | Jennifer Way | Internal Medicine | 4455 W 117th St Ste 300, Hawthorne, CA 90250-2240 | 2013-04-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710590450 | Napa Valley Internal Medicine | Internal Medicine | 999 Adams St Ste 201, Saint Helena, CA 94574-1149 | 2020-08-24 |
| 1821612565 | Almoutaz Bellah Shakally Md, Inc | Internal Medicine | 7462 Schuyler Ct, Rancho Cucamonga, CA 91730-8305 | 2020-05-28 |
| 1366061863 | Karen L. Herbst, Md, PC | Internal Medicine | 12381 Wilshire Blvd Ste 202, Los Angeles, CA 90025-1063 | 2020-04-14 |
| 1619502572 | Pacific Endocrinology | Internal Medicine | 1855 1st Ave Ste 200b, San Diego, CA 92101-2685 | 2020-03-11 |
| 1659910743 | Robert Alan Rubin | Internal Medicine | 403 Paseo Miramar, Redondo Beach, CA 90277-6288 | 2020-01-06 |
| 1124585393 | Steady Health Inc | Internal Medicine | 100 Bush St Ste 1600, San Francisco, CA 94104-3918 | 2019-02-25 |
| 1780140673 | Jennifer Anne Nuovo | Internal Medicine | 8880 Cal Center Dr Ste 300, Sacramento, CA 95826-3228 | 2019-02-15 |
| 1407324379 | Chrysalis Health of California | Internal Medicine | 4592 Camino Del Mirasol, Santa Barbara, CA 93110-1003 | 2018-11-08 |
| 1881172864 | Todd Lorenz | Internal Medicine | 5 Robert Rd, Orinda, CA 94563-3215 | 2018-08-01 |
| 1356845440 | Alain Baron | Internal Medicine | 12863 Baywind Pt, San Diego, CA 92130-2796 | 2018-03-22 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.