| Morningside Primary Care Medical Ctr, Inc | |
|
1704 W Manchester Ave Suite 101 Los Angeles CA 90047-3034 | |
| (323) 778-6215 | |
| (323) 778-6312 |
| Full Name | Morningside Primary Care Medical Ctr, Inc |
|---|---|
| Speciality | General Practice |
| Location | 1704 W Manchester Ave, Los Angeles, California |
| Authorized Official Name and Position | Lemmon C Mcmillan (PRESIDENT) |
| Authorized Official Contact | 3237786215 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Morningside Primary Care Medical Ctr, Inc 1704 W Manchester Ave Suite 101 Los Angeles CA 90047-3034 Ph: (323) 778-6215 | Morningside Primary Care Medical Ctr, Inc 1704 W Manchester Ave Suite 101 Los Angeles CA 90047-3034 Ph: (323) 778-6215 |
| NPI Number | 1083643837 |
|---|---|
| Provider Enumeration Date | 07/02/2006 |
| Last Update Date | 12/17/2014 |
| Medicare PECOS PAC ID | 4688766322 |
|---|---|
| Medicare Enrollment ID | O20070824000820 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083643837 | NPI | - | NPPES |
| GR0059700 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Chancelor Daniel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811927031 PECOS PAC ID: 7517908247 Enrollment ID: I20050512000712 |
| Provider Name | Gwenervere L Flagg |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1548216674 PECOS PAC ID: 6608872114 Enrollment ID: I20061005000533 |
| Provider Name | Jimmy H Soliman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770517278 PECOS PAC ID: 8729170238 Enrollment ID: I20070828000548 |
Joseph I Kang Md Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3755 Beverly Blvd, Ste 301, Los Angeles, CA 90004 Phone: 323-664-7777 | |
Clinica Virgen De Guadalupe Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 985 W Vernon Ave, Los Angeles, CA 90037 Phone: 323-234-6300 | |
Ssg San Pedro Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5811 S San Pedro St, Los Angeles, CA 90011 Phone: 213-553-1800 | |
John L Sherman Md Amc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8635 W 3rd St Ste 485w, Los Angeles, CA 90048 Phone: 310-855-8081 Fax: 310-855-0438 | |
Altamed Medical Group Eapc Prop 99 Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 500 Citadel Dr, Ste 490, Los Angeles, CA 90040 Phone: 323-725-8751 Fax: 323-889-7399 | |
Altamed Health Services Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5425 Pomona Blvd, Los Angeles, CA 90022 Phone: 323-832-7527 Fax: 323-832-7599 | |
Apla Health & Wellness - David Geffen Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 611 S Kingsley Dr, Los Angeles, CA 90005 Phone: 213-201-1623 Fax: 213-201-1595 |