MEDICARE: LANMC CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3104A0625X	Assisted Living Facility (Mental Illness)

General Provider Information

NPI Number	:	1134294275
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LANMC CORPORATION

Provider Business Mailing Address
First Line	:	9808 VENICE BLVD
Second Line	:	706
City	:	CULVER CITY
State	:	CA
Zip	:	90232-2732
Country	:	US
Telephone Number	:	310-839-3200
Fax Number	:	310-839-1247

Provider Business Practice Location Address
First Line	:	1920 S ROBERTSON BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90034-1129
Country	:	US
Telephone Number	:	310-559-9144
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	AMNON LICHT
Credential	:	MD
Telephone Number	:	310-839-3200

Provider Enumeration Date	:	11/22/2006
Last Update Date	:	08/22/2020

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Directions to “LANMC CORPORATION ” Practice Location

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