NORTHEAST COMMUNITY CLINIC (NPI# 1972786051) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972786051 |
| Entity Type | Organization |
| Organization Name | NORTHEAST COMMUNITY CLINIC |
| Practice Address |
5428 N Figueroa St Los Angeles CA 90042-4118 |
| Mailing Address |
2550 W Main St Suite 301 Alhambra CA 91801-1694 |
| Practice Telephone | 3232563884 |
| Practice Fax Number | 3232586307 |
| Mailing Telephone | 6264576900 |
| Mailing Fax Number | 6264575022 |
| Enumeration Date | 2007-12-11 |
| Last Update Date | 2008-09-18 |
| Authorized Official Name | CHRISTOPHER TAK LAU (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6264576900 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | NORTHEAST COMMUNITY CLINIC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | BCP11584G | CA | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | BCP11584G | CA | Allopathic & Osteopathic Physicians |
| N | 207V00000X | Obstetrics & Gynecology | BCP11584G | CA | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | BCP11584G | CA | Allopathic & Osteopathic Physicians |
| N | 363A00000X | Physician Assistant | BCP11584G | CA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363L00000X | Nurse Practitioner | BCP11584G | CA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
BCP11584G | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
BCP11584G | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | BCP11584G | 05 |
| 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 |
| 1336790914 | Northeast Community Clinic | Internal Medicine | 4455 W 117th St Ste 502, Hawthorne, CA 90250-2261 | 2019-09-24 |
| 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 |
5428 N FIGUEROA ST |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90042-4118 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386015857 | Nicholas Eldon Pisca | Marriage & Family Therapist | 5428 N Figueroa St, Los Angeles, CA 90042-4118 | 2015-10-09 |
| 1528242872 | Northeast Community Clinic | Internal Medicine | 5428 N Figueroa St, Los Angeles, CA 90042-4118 | 2007-12-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972140432 | Oak and Stone Marriage and Family Therapy, Inc. | Marriage & Family Therapist | 5619 North Figueroa Street, #212, Los Angeles, CA 90042 | 2019-12-04 |
| 1730640624 | Maria Guadalupe Bykowski | Nurse Practitioner | Family Care Specialists, 5823 York Blvd, Suite #1, Los Angeles, CA 90042 | 2019-03-25 |
| 1366935892 | Chris Scott | Physical Therapist | 4295 Via Arbolada #103, Los Angeles, CA 90042 | 2018-06-09 |
| 1043744055 | Magdalene Elise Wilhelm | Counselor | 4210 Via Arbolada, Unit 313, Los Angeles, CA 90042 | 2017-04-17 |
| 1669918967 | Sara Semal | Counselor | 5140 1/2 York Blvd, Los Angeles, CA 90042 | 2017-01-10 |
| 1164977427 | Jennifer Ann Walters | Marriage & Family Therapist | 4809 York Blvd, Los Angeles, CA 90042 | 2016-08-16 |
| 1073922415 | Michael Gerald Bauer | Marriage & Family Therapist | 5619 N. Figueroa Street, #223, Los Angeles, CA 90042 | 2014-08-11 |
| 1639519770 | Adam Cloe | Pathology | 6033 Hillandale Dr, Los Angeles, CA 90042 | 2013-07-03 |
| 1730480682 | Stat Response Ambulance, Inc. | Secured Medical Transport (VAN) | 4750 York Blvd., Los Angeles, CA 90042 | 2010-11-09 |
| 1427295377 | Carmen Castellon | Dental Assistant | 5807 M Figueroa St, Los Angeles, CA 90042 | 2009-01-14 |
| Find all providers in zip 90042 | ||||
| Taxonomy Code | 363LW0102X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Women's Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548760606 | Mary Walton | Nurse Practitioner | 1578 Colorado Blvd Ste B, Los Angeles, CA 90041-1451 | 2018-02-15 |
| 1013459981 | Scarlett Vanessa Grandy | Nurse Practitioner | 1513 S Grand Ave Ste 220, Los Angeles, CA 90015-3075 | 2016-11-09 |
| 1437609534 | Melissa Wilhelm | Nurse Practitioner | 8631 W 3rd St Ste 510, Los Angeles, CA 90048 | 2016-10-12 |
| 1710261177 | Julia Reger | Nurse Practitioner | 554 N Plymouth Blvd, Los Angeles, CA 90004-1411 | 2011-10-04 |
| 1992083877 | Talya Waldman | Nurse Practitioner | 8631 W Third Street, Suite 740 East, Los Angeles, CA 90048 | 2011-07-27 |
| 1548568728 | Marion M Mayer | Nurse Practitioner | 9911 West Pico Blvd Suite 500, Los Angeles, CA 90035 | 2011-03-11 |
| 1962664136 | Judy B Wittenberg Bravard | Nurse Practitioner | 11101 Venice Blvd, Los Angeles, CA 90034-6914 | 2008-06-30 |
| 1205024171 | Virginia Villegas | Nurse Practitioner | 4156 S Central Ave, Los Angeles, CA 90011-3154 | 2007-10-04 |
| 1003037466 | Antoinette Zaragoza | Nurse Practitioner | 245 S. Fetterly Ave, Roybal Comprehensive Chc, Los Angeles, CA 90022-0000 | 2007-05-02 |
| 1346306917 | Cherokee Lynette Lavalley | Nurse Practitioner | 10024 S Vermont Ave, Los Angeles, CA 90044-3112 | 2006-12-28 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90042 |
Please comment or provide details below to improve the information on NORTHEAST COMMUNITY CLINIC.
| 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.