Morningside Primary Care Medical Center MC Inc a Nevada Corporation

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

License

45227 Issued in CA

Legal business name

MORNINGSIDE PRIMARY CARE MEDICAL CENTER MC INC A NEVADA CORPORATION

Practice address

617 W Manchester Ave
Los Angeles, CA 90044-5718

Phone

(323) 778-6215

NPI assigned

Jul 24, 2014

Organization subpart

Yes

Parent organization

MEDVANTX, INC.As reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kenny Heine

Title

VP of Operations

Phone

(858) 964-1506

Specialties & licenses 1

Addresses

Other names 1

• Morningside Primary Care Medical Center Inc Doing business as

Tax ID family

Morningside Primary Care Medical Ctr Inc2 organizations share this tax ID, including this one

Part of

Tri - State Medical Group Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Morningside Primary Care

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1730299157
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1406160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406160000000",
    "number": "1255749099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5626 OBERLIN DR",
            "address_2": "SUITE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 W MANCHESTER AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900445718",
            "telephone_number": "323-778-6215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORNINGSIDE PRIMARY CARE MEDICAL CENTER MC INC A NEVADA CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC.",
        "enumeration_date": "2014-07-24",
        "last_updated": "2014-07-24",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "858-964-1506"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "CA",
            "license": "45227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Morningside Primary Care Medical Center Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rosa S Morng, PHARMACY TECHINICIAN
• Morning Calm Psychotherapy, Inc.
• Morningside Medical Pharmacy, Inc.
• Morningside Medical Pharmacy,Inc
• Morningside Primary Care
• Morningside Primary Care Medical Ctr, Inc
• Morningside Specialty Hospital Inc.
• Thomas Earl Morningstar
• Sandra Carole Moro, OTR.L
• Mark Vincent Morocco, M.D.

• Non-Pharmacy Dispensing Site in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Non-Pharmacy Dispensing Site in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.