Landmark Medical Services

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

1033260001 Issued in CA

Legal business name

LANDMARK MEDICAL SERVICES

Practice address

12981 Perris Blvd
Suite 111
Moreno Valley, CA 92553-4102

Phone

(951) 488-9577

Fax

(951) 488-9576

NPI assigned

Oct 27, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Celsus Etuk

Title

Manager

Phone

(951) 488-9577

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649356049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12981 PERRIS BLVD",
            "address_2": "SUITE 111",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925534102",
            "telephone_number": "951-488-9577",
            "fax_number": "951-488-9576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12981 PERRIS BLVD",
            "address_2": "SUITE 111",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925534102",
            "telephone_number": "951-488-9577",
            "fax_number": "951-488-9576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANDMARK MEDICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ETUK",
        "authorized_official_first_name": "CELSUS",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "951-488-9577"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "1033260001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.