Individual provider Active NPI

Michael D. Landman, M.D.

  • Otolaryngology Physician
  • Tarzana, CA
National Provider Identifier
1245237833
Registry record updated Aug 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
A22817 Issued in CA
Practice address
5525 Etiwanda Ave
Ste 312
Tarzana, CA 91356-6126
Phone
(818) 609-0600
NPI assigned
Jun 28, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X A22817 CA Primary

Addresses

Primary practice location

5525 Etiwanda Ave
Ste 312
Tarzana, CA 91356-6126

Mailing address

5525 Etiwanda Ave
Ste 312
Tarzana, CA 91356-6126
Phone (818) 609-0600

Other identifiers 1

IdentifierTypeStateIssuer
00A228170MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031119000904 CA Practitioner - Otolaryngology 7315841624

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
22817CAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344902400000",
    "number": "1245237833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5525 ETIWANDA AVE",
            "address_2": "STE 312",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913566126",
            "telephone_number": "818-609-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5525 ETIWANDA AVE",
            "address_2": "STE 312",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913566126",
            "telephone_number": "818-609-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDMAN",
        "first_name": "MICHAEL",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-28",
        "last_updated": "2012-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A22817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A228170",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarzana, CA

Sources for this page

Verify at the official NPI Registry.