Organization
LANDMARK IMAGING MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY M. SILVERMAN M.D. (PRESIDENT)
(310) 914-7336
Entity
Organization
Contact information
Practice address
11620 WILSHIRE BLVD, STE. 100, LOS ANGELES, CA 90025-1706
(310) 914-7336
(310) 914-7326
Mailing address
PO BOX 5667, ORANGE, CA 92863-5667
(888) 598-8820
(714) 571-5055
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CJ5919
RAILROAD MEDICARE
—
05
—
GR0091540
—
CA
01
—
ZZZ02770Z
BLUE SHIELD OF CA
—
Enumeration date
07/09/2006
Last updated
08/15/2008
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