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
Update your record
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