Landis, Kenneth Wayne
Landis, Kenneth Wayne is an sole proprietor health care provider with primary practice located at 4477 W 118Th St Ste 401 , Hawthorne CA 90250-2269. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Landis, Kenneth Wayne can be contacted via phone (310) 822-2255.Contact Information
Primary practice address
4477 W 118Th St Ste 401
Hawthorne CA 90250-2269
Phone: (310) 822-2255
Fax: (310) 970-1979
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | G29787 | California |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | G29787 | California |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | G29787 | California |
Profile Details
| NPI number | 1861463077 |
|---|---|
| LBN Legal business name | Landis, Kenneth Wayne |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 27th, 2006 |
| Last updated | Nov 14th, 2019 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1861463077 | NPPES |
| Other | 290003222 | RAILROAD RETIREMENT BOARD | |
| MEDICAID | 00G297870 | RAILROAD RETIREMENT BOARD | |
| Other | CP9010 | RAILROAD RETIREMENT BOARD |
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