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1871206300
LL PROVIDER INC
GARDEN GROVE, CA
NPI
1871206300
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Entity Type
Organization
Authorized Contact
LORNA LOGAN
Founder
949-861-0127
Organization Subpart ?
No
Primary Taxonomy
261QP2300X Clinic/Center, Primary Care
Enumeration Date
2022-12-29
Last Update Date
2022-12-29
Business Address
LL PROVIDER INC
12668 CHAPMAN AVE UNIT 2107
GARDEN GROVE, CA 92840-4037
Phone number: 949-861-0127
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Mailing Address
LL PROVIDER INC
12668 CHAPMAN AVE UNIT 2107
GARDEN GROVE, CA 92840-4037
Phone number: 949-861-0127
Copy
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