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NORTHEAST COMMUNITY CLINIC NPI 1124460274


NPI Information

NPI: 1124460274
Provider Name: NORTHEAST COMMUNITY CLINIC

Doing Business As: NECC - GAGE HEALTH CENTER

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 05D0694067

Address:
2975 ZOE AVE
HUNTINGTON PARK, CA
ZIP 90255
Phone: (323) 771-8400
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NORTHEAST COMMUNITY CLINIC is a federally qualified health center (fqhc) clinic center in Huntington Park, CA. NORTHEAST COMMUNITY CLINIC NPI is 1124460274. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Necc - Gage Health Center.

The provider's business location address is:

2975 ZOE AVE
HUNTINGTON PARK, CA
ZIP 90255
Phone: (323) 771-8400
Fax: (323) 582-8500

The provider's authorized official is Christopher Lau .
The authorized official title is Executive Director and has the following contact phone number (626) 457-6900.

The CLIA number assigned to this NPI record is 05D0694067 - community clinic with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 7/17/2013 and was last updated on 6/12/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineNo
2207QG0300XFamily MedicineGeriatric MedicineNo
3208000000XPediatricsNo
42080A0000XPediatricsAdolescent MedicineNo
5261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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