Provider Demographics
NPI:1114382421
Name:HOPE COMMUNITY CARE CLINIC, INC.
Entity Type:Organization
Organization Name:HOPE COMMUNITY CARE CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMVALIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-853-2220
Mailing Address - Street 1:1141 N BRAND BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202-2577
Mailing Address - Country:US
Mailing Address - Phone:818-853-2220
Mailing Address - Fax:818-853-2221
Practice Address - Street 1:11273 LAUREL CANYON BLVD STE 2
Practice Address - Street 2:
Practice Address - City:SAN FERNANDO
Practice Address - State:CA
Practice Address - Zip Code:91340-4357
Practice Address - Country:US
Practice Address - Phone:818-853-2220
Practice Address - Fax:818-853-2221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-31
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty