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Organization

JOSEPH W LANDAU M D A MEDICAL CORP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOSEPH W LANDAU M.D. (PRESIDENT/SECRETARY)
(310) 828-4494
Entity
Organization

Contact information

Practice address
2428 SANTA MONICA BLVD, STE 401, SANTA MONICA, CA 90404-2047
(310) 828-4494
(310) 828-3254
Mailing address
2428 SANTA MONICA BLVD, STE 401, SANTA MONICA, CA 90404-2047
(310) 828-4494
(310) 828-3254

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
G4281
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000G42810
CA
01
05D0549998
CLIA
CA
01
1609801760
VARIOUS INSURANCE COMPANIES
CA
01
G4281
VARIOUS INSURANCE COMPANIES
CA
Enumeration date
08/10/2009
Last updated
08/21/2009
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