Provider Demographics
NPI:1710500483
Name:HMG COMMUNITY CLINIC INC,
Entity type:Organization
Organization Name:HMG COMMUNITY CLINIC INC,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING AND BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HASMIK
Authorized Official - Middle Name:JASMINE
Authorized Official - Last Name:AVETISYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-294-7997
Mailing Address - Street 1:44215 15TH ST W STE 315
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-5505
Mailing Address - Country:US
Mailing Address - Phone:661-945-4581
Mailing Address - Fax:661-949-5887
Practice Address - Street 1:44215 15TH ST W STE 315
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-5505
Practice Address - Country:US
Practice Address - Phone:661-945-4581
Practice Address - Fax:661-949-5887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-28
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty