Robert Martin Landaw, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

G9814 Issued in CA

Practice address

11633 San Vicente Blvd
#206
La, CA 90049-6513

Phone

(310) 826-5513

Fax

(310) 820-1606

NPI assigned

Feb 12, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Valerie L. Watiker M.D. Inc

  • Primary Care Clinic/Center
  • Los Angeles, CA
  • NPI 1669627808
  NPD (past)

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306988977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11633 SAN VICENTE BLVD",
            "address_2": "#206",
            "city": "LA",
            "state": "CA",
            "postal_code": "900496513",
            "telephone_number": "310-826-5513",
            "fax_number": "310-820-1606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11633 SAN VICENTE BLVD",
            "address_2": "#206",
            "city": "LA",
            "state": "CA",
            "postal_code": "900496513",
            "telephone_number": "310-826-5513",
            "fax_number": "310-820-1606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDAW",
        "first_name": "ROBERT",
        "middle_name": "MARTIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G9814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• KLM Home Health, Incorporated
• Arusyak Knadzyan
• Suran Ko, LMFT
• Suet Mui Kong, MSW-TRAINEE
• Nicole Kumle
• Pouya Lavian
• Joon Beom Lee, ASW-REGISTERED
• Seung Jin Lee, MFT-TRAINEE
• Melody Y Liao, CARE COORDINATOR
• Jennifer S. Lin, LCSW

• All providers in La, CA
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.