LL Provider Inc

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

LL PROVIDER INC

Practice address

12668 Chapman Ave Unit 2107
Garden Grove, CA 92840-4037

Phone

(949) 861-0127

NPI assigned

Dec 29, 2022

Last updated

Dec 29, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lorna Logan

Title

Founder

Phone

(949) 861-0127

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1672272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672272000000",
    "number": "1871206300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12668 CHAPMAN AVE UNIT 2107",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928404037",
            "telephone_number": "949-861-0127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12668 CHAPMAN AVE UNIT 2107",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928404037",
            "telephone_number": "949-861-0127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LL PROVIDER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-29",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-29",
        "status": "A",
        "authorized_official_last_name": "LOGAN",
        "authorized_official_first_name": "LORNA",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "949-861-0127"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2022; 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.