Organization
MORNINGSIDE PRIMARY CARE MEDICAL CTR, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEMMON C MCMILLAN M.D. (PRESIDENT)
(323) 778-6215
Entity
Organization
Contact information
Practice address
1704 W MANCHESTER AVE, SUITE 101, LOS ANGELES, CA 90047-3034
(323) 778-6215
(323) 778-6312
Mailing address
1704 W MANCHESTER AVE, SUITE 101, LOS ANGELES, CA 90047-3034
(323) 778-6215
(323) 778-6312
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0059700
—
CA
Enumeration date
07/02/2006
Last updated
12/17/2014
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