Provider Demographics
NPI:1437268505
Name:LANDMAN, JAIME (MD)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:
Last Name:LANDMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 CITY BLVD W
Mailing Address - Street 2:SUITE 2100
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-2903
Mailing Address - Country:US
Mailing Address - Phone:714-456-6054
Mailing Address - Fax:888-378-5391
Practice Address - Street 1:101 THE CITY DR S
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3201
Practice Address - Country:US
Practice Address - Phone:714-456-7005
Practice Address - Fax:714-456-5062
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG88840208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G88400Medicaid
CAP01046269OtherMEDICARE -RAILROAD
CAP01046269OtherMEDICARE -RAILROAD
NY198545OtherHIP
NY7107024OtherAETNA
NY760791551Other1199
NY3C9465OtherHEALTHNET
NY7852717OtherCIGNA
NY760791551OtherPHCS
NY4S0321OtherEMPIRE BCBS
NYP3603734OtherOXFORD