| NPI | 1568607539 |
|---|---|
| Doing Business As | NORTHEAST COMMUNITY CLINIC MOBILE MEDICAL VAN |
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER TAK LAU Executive Director 626-457-6900 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2008-12-04 |
| Last Update Date | 2021-10-15 |