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KENNETH LANDIS M D A MEDICAL CORPORATION NPI 1184799520


NPI Information

NPI: 1184799520
Provider Name: KENNETH LANDIS M D A MEDICAL CORPORATION
Classification: Internal Medicine - 207R00000X
Entity Type: Organization
Address:
4644 LINCOLN BLVD
SUITE 500
MARINA DEL REY, CA
ZIP 90292
Phone: (310) 822-2255
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KENNETH LANDIS M D A MEDICAL CORPORATION is an internal medicine in Marina Del Rey, CA. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. KENNETH LANDIS M D A MEDICAL CORPORATION NPI is 1184799520. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4644 LINCOLN BLVD
SUITE 500
MARINA DEL REY, CA
ZIP 90292-313
Phone: (310) 822-2255
Fax: (310) 822-0044

The provider's authorized official is Kenneth Wayne Landis .
The authorized official title is President and has the following contact phone number (310) 822-2255.

The enumeration date for this NPI number is 11/21/2006 and was last updated on 4/20/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RC0200XInternal MedicineCritical Care MedicineG29787CALIFORNIANo
2207RP1001XInternal MedicinePulmonary DiseaseG29787CALIFORNIANo
3207R00000XInternal MedicineG29787CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1290003222OTHERCALIFORNIARAILROAD MEDICARE
200G297871MEDICAIDCALIFORNIA
300G297870MEDICAIDCALIFORNIA
4CP9010OTHERMEDICARE RRR

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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