Healthcare Provider Details

I. General information

NPI: 1043345861
Provider Name (Legal Business Name): BARBARA ANNE LANDESMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

827 22ND ST
SANTA MONICA CA
90403-2008
US

IV. Provider business mailing address

1908 THOMES AVE STE 12550
CHEYENNE WY
82001-3527
US

V. Phone/Fax

Practice location:
  • Phone: 303-776-5298
  • Fax:
Mailing address:
  • Phone: 303-776-5298
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA93333
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberTM2010-0152
License Number StateNM
# 3
Primary TaxonomyY
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License NumberDR0052714
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: