# MORNINGSIDE PRIMARY CARE MEDICAL CTR, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083643837
- **Authorized official:** MR. LEMMON C MCMILLAN M.D. (PRESIDENT)
- **Authorized official phone:** (323) 778-6215

## Contact information

- **Practice address:** 1704 W MANCHESTER AVE, SUITE 101, LOS ANGELES, CA 90047-3034
- **Practice address phone:** (323) 778-6215
- **Practice address fax:** (323) 778-6312
- **Mailing address:** 1704 W MANCHESTER AVE, SUITE 101, LOS ANGELES, CA 90047-3034
- **Mailing address phone:** (323) 778-6215
- **Mailing address fax:** (323) 778-6312

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/02/2006
- **Last updated:** 12/17/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | GR0059700 | — | CA |