NORTHEAST COMMUNITY CLINIC


Address: 4455 W 117th St Ste 200, Hawthorne, CA 90250-2240
Phone: 3102192000

NORTHEAST COMMUNITY CLINIC (NPI# 1962050120) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1962050120
Entity Type Organization
Organization Name NORTHEAST COMMUNITY CLINIC
Practice Address 4455 W 117th St Ste 200
Hawthorne
CA 90250-2240
Mailing Address 2550 W Main St Ste 301
Alhambra
CA 91801-7003
Practice Telephone 3102192000
Practice Fax Number 3102192001
Mailing Telephone 6264576900
Enumeration Date 2019-08-30
Last Update Date 2019-08-30
Authorized Official Name CHRISTOPHER TAK LAU (EXECUTIVE DIRECTOR)
Authorized Official Telephone 6264576900
Authorized Official Credential MD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207R00000X Internal Medicine Allopathic & Osteopathic Physicians
N 261QF0400X Clinic/Center
Specialization: Federally Qualified Health Center (FQHC)
Ambulatory Health Care Facilities
Y 207V00000X Obstetrics & Gynecology Allopathic & Osteopathic Physicians

Other Provider IDs and Locations

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
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
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

Office Location

Street Address 4455 W 117TH ST STE 200
City HAWTHORNE
State CA
Zip Code 90250-2240

Providers in the same location

NPI Name Taxonomy Address Enumeration
1770617755 Dunia Lizzeth Ponce Nurse Practitioner 4455 W 117th St Ste 200, Hawthorne, CA 90250-2240 2007-03-14

Providers in the same zip code

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 Information

Taxonomy Code 207V00000X
Grouping Allopathic & Osteopathic Physicians
Classification Obstetrics & Gynecology

Taxonomy Definition

An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1629685730 Farshid Moossazadeh, M.d., A Professional Corporation Obstetrics & Gynecology 11633 Hawthorne Blvd Ste 300, Hawthorne, CA 90250-2369 2020-09-23
1194152348 Patrick Popiel Obstetrics & Gynecology 19 Bradhurst Ave # S3750s, Hawthorne, NY 10532-2140 2013-10-02
1710250519 P K Sehdeva Md A Professional Corporation Obstetrics & Gynecology 12321 Hawthorne Blvd., Hawthorne, CA 90250 2012-02-10
1871753376 Gylynthia E. Trotman Obstetrics & Gynecology 40 Saw Mill River Rd Ste Ll-4, Hawthorne, NY 10532-1535 2008-06-10
1083751184 Cara Louise Grimes Obstetrics & Gynecology 19 Bradhurst Ave Ste 2700, Hawthorne, NY 10532-2170 2007-01-30
1548293145 Parkash K. Sehdeva Obstetrics & Gynecology 12321 Hawthorne Blvd, Suite A, Hawthorne, CA 90250-3808 2006-07-08
1497736847 Timothy Edward Ryntz Obstetrics & Gynecology 19 Bradhurst Ave Ste 2700s, Hawthorne, NY 10532-2140 2005-11-10
1467454967 Boston Children's Health Physicians, LLP Obstetrics & Gynecology 19 Skyline Dr Ofc 1n-d06, Hawthorne, NY 10532 2005-08-15
1083068258 Anita Mikkilineni Obstetrics & Gynecology 19 Bradhurst Ave Ste 2750s, Hawthorne, NY 10532-2140 2016-04-14
1285989715 Jose Juan Vicens-villafana Obstetrics & Gynecology 19 Bradhurst Ave, Suite 2700s, Hawthorne, NY 10532-2140 2012-07-20
Find all providers in HAWTHORNE

Competitor

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City HAWTHORNE
Zip Code 90250

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Dataset Information

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.

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