Healthcare Provider Details

I. General information

NPI: 1821919846
Provider Name (Legal Business Name): ASHLEY LANDSMAN MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3940-7 BROAD STREET 221
SAN LUIS OBISPO CA
93401
US

IV. Provider business mailing address

3940-7 BROAD STREET 221
SAN LUIS OBISPO CA
93401
US

V. Phone/Fax

Practice location:
  • Phone: 210-860-6417
  • Fax: 805-249-1005
Mailing address:
  • Phone: 210-860-6417
  • Fax: 805-249-1005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. ASHLEY LANDSMAN
Title or Position: PRESIDENT
Credential: MD
Phone: 210-860-6417