NORTHEAST COMMUNITY CLINIC – NPI #1164606414
Clinic/Center

NORTHEAST COMMUNITY CLINIC is an AHC clinic located in LOS ANGELES, CA. NPPES has assigned the NPI number 1164606414 to NORTHEAST COMMUNITY CLINIC on December 21, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QF0400X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Federally Qualified Health Center (FQHC)

The NPI profile was previously updated about 5 years ago on Oct 15, 2021. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for NORTHEAST COMMUNITY CLINIC below.

NPI Profile for
NORTHEAST COMMUNITY CLINIC

NPI Number
1164606414
Enumeration Date

(more than 18 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
NORTHEAST COMMUNITY CLINIC
Primary location
5420 N FIGUEROA ST
LOS ANGELES, CA 90042
Phone: (323) 256-3884 Fax: (323) 258-6307
Mailing address
2550 W MAIN ST
SUITE 301
ALHAMBRA, CA 91801-1694
Phone: (626) 457-6900 Fax: (626) 457-1233
Organization Subpart
Yes - NORTHEAST COMMUNITY CLINIC is subpart of another organization.
Authorized Official
CHRISTOPHER LAU
EXECUTIVE DIRECTOR
Phone: (626) 457-6900
Updated
Certification Date
Oct 15, 2021

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for NORTHEAST COMMUNITY CLINIC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDCAHAP11584G
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QF0400X
- Clinic/Center / Federally Qualified Health Center (FQHC) (Primary)
207V00000X
- Obstetrics & Gynecology		 CA HAP11584G
207R00000X
- Internal Medicine		 CA HAP11584G

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.