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General NPI Number Information
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NPI Number | 1053609438
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Entity Type | Organization
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Legal Business Name | LAYNE KUMETZ M.D., INC.
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Dates
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Enumeration Date | 07/19/2011
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Last Update Date | 08/29/2017
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Provider Practice Location Address
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Address Line | 6330 SAN VICENTE BLVD SUITE 300
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City | LOS ANGELES
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State | CA
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Zip | 90048-5425
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Country | US
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Telephone | 323-634-9996
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Fax | 323-634-9929
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Provider Business Mailing Address
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Address Line | 6330 SAN VICENTE BLVD SUITE 300
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City | LOS ANGELES
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State | CA
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Zip | 90048-5425
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Country | US
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Telephone | 323-634-9996
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Fax | 323-634-9929
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | JAMES KNOTT
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Credential |
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Telephone | 310-425-2322
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | A91538
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License Number State | CA
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