Organization Active NPI

Landmark Imaging Medical Group, Inc.

  • Diagnostic Radiology Physician
  • Los Angeles, CA
National Provider Identifier
1124051354
Registry record updated Aug 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
LANDMARK IMAGING MEDICAL GROUP, INC.
Practice address
11620 Wilshire Blvd
Ste. 100
Los Angeles, CA 90025-1706
Phone
(310) 914-7336
Fax
(310) 914-7326
NPI assigned
Jul 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jeffrey M. Silverman, M.D.
Title
President
Phone
(310) 914-7336

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

11620 Wilshire Blvd
Ste. 100
Los Angeles, CA 90025-1706

Mailing address

PO Box 5667
Orange, CA 92863-5667
Phone (888) 598-8820

Other identifiers 3

IdentifierTypeStateIssuer
ZZZ02770ZOtherBLUE SHIELD OF CA
GR0091540MedicaidCA
CJ5919OtherRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

11620 Wilshire Blvd
Fl 10
Los Angeles, CA 90025
Phone (310) 914-7336

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218758400000",
    "number": "1124051354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5667",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928635667",
            "telephone_number": "888-598-8820",
            "fax_number": "714-571-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11620 WILSHIRE BLVD",
            "address_2": "STE. 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251706",
            "telephone_number": "310-914-7336",
            "fax_number": "310-914-7326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANDMARK IMAGING MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2008-08-15",
        "status": "A",
        "authorized_official_last_name": "SILVERMAN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-914-7336",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA",
            "identifier": "ZZZ02770Z",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0091540",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CJ5919",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.