| Independence Community Treatment Clinic | |
|
19231 Victory Blvd Suite 554 Reseda CA 91335-6308 | |
| (818) 776-1755 | |
| (818) 776-1657 |
| Full Name | Independence Community Treatment Clinic |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 19231 Victory Blvd, Reseda, California |
| Authorized Official Name and Position | Rebecca Greenough (ASST. PROGRAM DIRECTOR) |
| Authorized Official Contact | 8187761755 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Independence Community Treatment Clinic 19231 Victory Blvd Suite 554 Reseda CA 91335-6308 Ph: (818) 776-1755 | Independence Community Treatment Clinic 19231 Victory Blvd Suite 554 Reseda CA 91335-6308 Ph: (818) 776-1755 |
| NPI Number | 1376677823 |
|---|---|
| Provider Enumeration Date | 03/15/2007 |
| Last Update Date | 01/06/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376677823 | NPI | - | NPPES |
| CMM70956F | Medicaid | CA | |
| 196856000 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | 960001358 (California) | Primary |
Clinica De La Merced Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7012 Reseda Blvd # 100, Reseda, CA 91335 Phone: 747-265-6423 Fax: 747-265-6424 | |
Bfm Visits Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 18305 Sherman Way Ste 3, Reseda, CA 91335 Phone: 818-477-0798 | |
Cisco Medical Group, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 18518 Sherman Way, Reseda, CA 91335 Phone: 818-757-0954 Fax: 818-757-0963 | |
Choice Providers Medical Group Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 17750 Sherman Way, Ste 101, Reseda, CA 91335 Phone: 818-705-7200 Fax: 818-343-0805 | |
Higher Doctor's Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 19231 Sherman Way Unit 23, Reseda, CA 91335 Phone: 818-220-4898 | |
Rst Medical Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 18040 Sherman Way Ste 210, Reseda, CA 91335 Phone: 818-796-2920 | |
Med Nation, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7012 Reseda Blvd., Suite A, Reseda, CA 91335 Phone: 818-776-1171 Fax: 818-776-1191 |