| Organization Name: | KENNETH LANDIS M D A MEDICAL CORPORATION |
| NPI Number: | 1184799520 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KENNETH WAYNE LANDIS (PRESIDENT) |
| Mailing Address: | 4644 Lincoln Blvd Suite 500 Marina Del Rey |
| State: | CA US |
| Postal Code: | 902926313 |
| Phone Number: | 3108222255 |
| Fax Number: | 3108220044 |
| NPI Enumeration Date: | 11/21/2006 |
| NPI Last Update Date: | 02/08/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207RC0200X |
| License Number: | G29787 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Internal Medicine |
| Taxonomy Specialization: | Critical Care Medicine |
| Taxonomy Definition: | An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |