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General NPI Number Information
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NPI Number | 1770035024
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Entity Type | Organization
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Legal Business Name | LANDMARK ANESTHESIA MEDICAL GROUP
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Dates
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Enumeration Date | 11/02/2016
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 3630 E IMPERIAL HWY
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City | LYNWOOD
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State | CA
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Zip | 90262-2609
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Country | US
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Telephone | 714-503-0195
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Fax | 714-676-8603
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Provider Business Mailing Address
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Address Line | 2271 W MALVERN AVE # 139
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City | FULLERTON
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State | CA
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Zip | 92833-2106
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Country | US
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Telephone | 714-503-0195
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Fax | 714-676-8603
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Authorized Official
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Title or Position | PRESIDENT
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Name | HANH NGUYEN CLARK
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Credential | MD
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Telephone | 949-903-4980
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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