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Organization
LANDMARK MEDICAL OF IDAHO PC
Active
Organization
LANDMARK MEDICAL OF IDAHO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL LE (CHIEF MEDICAL OFFICER)
(657) 400-5180
Entity
Organization
Contact information
Practice address
322 E FRONT ST STE 400, BOISE, ID 83702-7370
(657) 400-5180
Mailing address
7755 CENTER AVE STE 630, HUNTINGTON BEACH, CA 92647-9152
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
10/07/2022
Last updated
10/07/2022
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