Individual
DR. JEFFREY KEITH LANDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
16300 SAND CANYON AVE, SUITE 612, IRVINE, CA 92618-3711
(949) 753-1001
(949) 753-1115
Mailing address
PO BOX 3602, SAN CLEMENTE, CA 92674-3602
(949) 485-1812
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A93332
CA
207ND0101X
MOHS-Micrographic Surgery Physician
A93332
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
WA93332B
MEDICARE PTAN
—
Enumeration date
06/14/2006
Last updated
01/16/2020
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