Provider Demographics
NPI:1467506220
Name:LANMAN, TODD H, (MD, FACS)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:H,
Last Name:LANMAN
Suffix:
Gender:M
Credentials:MD, FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 S SPALDING DR
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-1800
Mailing Address - Country:US
Mailing Address - Phone:310-385-7766
Mailing Address - Fax:310-385-9007
Practice Address - Street 1:120 S SPALDING DR
Practice Address - Street 2:SUITE 400
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-1800
Practice Address - Country:US
Practice Address - Phone:310-385-7766
Practice Address - Fax:310-385-9007
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA40938174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAL2696043OtherDEA NUMBER
CAE29483Medicare UPIN