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Organization

HAWTHORNE MORNINGSIDE MEDICAL CLINIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LEMMON MCMILLAN MD (OWNER)
(310) 901-4714
Entity
Organization

Contact information

Practice address
12954 HAWTHORNE BLVD, SUITE 104, HAWTHORNE, CA 90250-4418
(310) 679-0269
(310) 679-1038
Mailing address
12954 HAWTHORNE BLVD, SUITE 104, HAWTHORNE, CA 90250-4418
(310) 679-0269
(310) 679-1038

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
G77541
CA
208000000X
Pediatrics Physician
Primary
A82810
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GR0092930
CA
Enumeration date
02/06/2007
Last updated
12/13/2011
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