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General NPI Number Information
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NPI Number | 1235344839
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Entity Type | Organization
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Legal Business Name | MCMILLAN PRIMARY CARE MEDICAL
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 3737 MARTIN LUTHER KING #105-106
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City | LYNWOOD
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State | CA
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Zip | 90262
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Country | US
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Telephone | 310-637-0318
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Fax | 310-637-6722
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Provider Business Mailing Address
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Address Line | 3737 MARTIN LUTHER KING #105-106
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City | LYNWOOD
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State | CA
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Zip | 90262
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Country | US
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Telephone | 310-637-0318
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Fax | 310-637-6722
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Authorized Official
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Title or Position | OWNER
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Name | DR. LEMMON C MCMILLAN
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Credential | MD
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Telephone | 310-637-0318
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | C34897
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | C34897
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License Number State | CA
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