MORNINGSIDE PRIMARY CARE MEDICAL CENTER MC INC A NEVADA CORPORATION (NPI# 1255749099) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255749099 |
| Entity Type | Organization |
| Organization Name | MORNINGSIDE PRIMARY CARE MEDICAL CENTER MC INC A NEVADA CORPORATION |
| Other Organization Name | MORNINGSIDE PRIMARY CARE MEDICAL CENTER INC |
| Practice Address |
617 W Manchester Ave Los Angeles CA 90044-5718 |
| Mailing Address |
5626 Oberlin Dr Suite 110 San Diego CA 92121-1705 |
| Practice Telephone | 3237786215 |
| Enumeration Date | 2014-07-24 |
| Last Update Date | 2014-07-24 |
| Authorized Official Name | KENNY HEINE (VP OF OPERATIONS) |
| Authorized Official Telephone | 8589641506 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEDVANTX, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | 45227 | CA | Suppliers |
| Other Name | Type Code |
|---|---|
| Morningside Primary Care Medical Center Inc | Doing Business As Name - Organization |
| Street Address |
617 W MANCHESTER AVE |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90044-5718 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770517278 | Jimmy H Soliman | Internal Medicine | 617 W Manchester Ave, Los Angeles, CA 90044-5718 | 2006-07-10 |
| 1245732155 | Barbara Nguyen | Nurse Practitioner | 617 W Manchester Ave, Los Angeles, CA 90044-5718 | 2018-03-06 |
| 1417211533 | Gold Standard Urology | Surgery | 617 W Manchester Ave, Los Angeles, CA 90044-5718 | 2012-07-03 |
| 1619196656 | Lemmon C Mcmillan | General Practice | 617 W Manchester Ave, Los Angeles, CA 90044-5718 | 2007-04-25 |
| 1730299157 | Morningside Primary Care | General Practice | 617 W Manchester Ave, Los Angeles, CA 90044-5718 | 2006-08-30 |
| 1932127024 | Charles Douglas Curtis | General Practice | 617 W Manchester Ave, Los Angeles, CA 90044-5718 | 2006-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386135671 | Park Professional Dental Corp | Dentist | 600 W Manchester Ave Ste 2, Los Angeles, CA 90044 | 2018-05-23 |
| 1851831218 | Latisha Samantha Carter | Licensed Vocational Nurse | 521 W 97th St., Los Angeles, CA 90044 | 2017-03-06 |
| 1669928230 | Travel & Ground Network Inc. | Non-emergency Medical Transport (VAN) | 605 West 113 Th. Street, Los Angeles, CA 90044 | 2016-09-01 |
| 1295100642 | Scharp | Community/Behavioral Health | 8836 Vermont Ave, Los Angeles, CA 90044 | 2015-12-10 |
| 1356714851 | Euna Lee | Pharmacist | 5822 S Vermont Avenue, Los Angeles, CA 90044 | 2015-11-05 |
| 1518384338 | Kiniko Willingham | Social Worker | 1050 W 91st St, Los Angles, CA 90044 | 2014-03-19 |
| 1619211422 | Los Angeles Christian Health Centers | Clinic/Center | 8511 1/2 Vermont Street, Los Angeles, CA 90044 | 2012-11-16 |
| 1891047510 | Yvonne Henderson | Marriage & Family Therapist | 8730 S. Vermont Ave, Los Angeles, CA 90044 | 2012-10-04 |
| 1669722534 | Diana Gutierrez | Counselor | 9001 S. Vermont Ave., Los Angeles, CA 90044 | 2012-09-18 |
| 1720343304 | Rocio Cortez | Counselor | 90001 South Vermont Ave, Los Angeles, CA 90044 | 2012-07-10 |
| Find all providers in zip 90044 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730624719 | St. John's Well Child and Family Center Inc | Non-Pharmacy Dispensing Site | 326 W 23rd St, Los Angeles, CA 90007-2612 | 2016-12-29 |
| 1932395092 | Glenville Medical Group, A Medical Corporation | Non-Pharmacy Dispensing Site | 1531 Glenville Dr, Los Angeles, CA 90035-3107 | 2007-09-21 |
| 1265441216 | Randy L Peters | Non-Pharmacy Dispensing Site | 3198 W 7th St Apt 318, Los Angeles, CA 90005-1659 | 2006-08-07 |
| 1891245619 | Keith L. Gurnick, D.p.m. | Non-Pharmacy Dispensing Site | 2080 Century Park E, Suite 705, Los Angeles, CA 90067-2001 | 2016-10-04 |
| 1770962946 | R Roland Lopez, M.d., Inc. | Non-Pharmacy Dispensing Site | 1711 W Temple St, Suite 4100, Los Angeles, CA 90026-5421 | 2015-05-21 |
| 1386021475 | R Roland Lopez, M.d., Inc. | Non-Pharmacy Dispensing Site | 5301 Whittier Blvd, Suite B, Los Angeles, CA 90022-4038 | 2015-04-28 |
| 1033501101 | Ais Medical Foods, Inc. | Non-Pharmacy Dispensing Site | 8631 W 3rd St, Suite 1145e, Los Angeles, CA 90048-5901 | 2015-02-26 |
| 1386058402 | Arj Medical, Inc. | Non-Pharmacy Dispensing Site | 5655 E Beverly Blvd, Los Angeles, CA 90022-2803 | 2014-06-17 |
| 1043624489 | Daniel Capen, M.d., A Professional Corporation | Non-Pharmacy Dispensing Site | 6200 Wilshire Blvd, Suite 910, Los Angeles, CA 90048-5801 | 2014-06-13 |
| 1023428521 | Pacific Rejuvenation Medical, A Professional Corp. | Non-Pharmacy Dispensing Site | 6310 San Vicente Blvd, Suite 220, Los Angeles, CA 90048-5426 | 2014-05-06 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90044 |
Please comment or provide details below to improve the information on MORNINGSIDE PRIMARY CARE MEDICAL CENTER MC INC A NEVADA CORPORATION.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.