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General NPI Number Information
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NPI Number | 1154888063
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Entity Type | Organization
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Legal Business Name | LANMC CORPORATION
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Dates
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Enumeration Date | 02/27/2019
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Last Update Date | 02/27/2019
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Provider Practice Location Address
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Address Line | 1920 S. ROBERTSON BLVD.
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City | LOS ANGELES
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State | CA
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Zip | 90034
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Country | US
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Telephone | 310-559-9144
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Fax |
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Provider Business Mailing Address
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Address Line | 9808 VENICE BLVD STE. 706
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City | CULVER CITY
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State | CA
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Zip | 90232-2718
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Country | US
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Telephone | 310-839-3200
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Fax | 310-839-1247
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Authorized Official
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Title or Position | PRESIDENT
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Name | AMNON LICHT
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Credential | M.D.
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Telephone | 310-994-8804
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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