# SUSAN SCHMIDT-LACKNER A PROFESSIONAL MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336077650
- **Authorized official:** SUSAN L SCHMIDT-LACKNER MD (PRESIDENT CEO, SECRETARY AND CFO,)
- **Authorized official phone:** (318) 869-9119

## Contact information

- **Practice address:** 1239 S CAMDEN DR, LOS ANGELES, CA 90035-1111
- **Practice address phone:** (310) 869-9119
- **Mailing address:** 1239 S CAMDEN DR, LOS ANGELES, CA 90035-1111
- **Mailing address phone:** (310) 869-9119

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | NULL | Yes |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/08/2026
- **Last updated:** 05/08/2026