Individual provider Active NPI

Earl K Landau, M.D.

  • Diagnostic Radiology Physician
  • Santa Monica, CA
National Provider Identifier
1295787984
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
C28197 Issued in CA
Practice address
2825 Santa Monica Blvd
Suite 301
Santa Monica, CA 90404-2429
Phone
(310) 829-3130
Fax
(310) 828-9156
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiologic Technologist 247100000X C28197 CA
Diagnostic Radiology Physician 2085R0202X C28197 CA Primary

Addresses

Primary practice location

2825 Santa Monica Blvd
Suite 301
Santa Monica, CA 90404-2429

Mailing address

4161 Redondo Beach Blvd
Suite 201
Lawndale, CA 90260-3306
Phone (310) 214-8677

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
I20100312000520 CA Practitioner - Diagnostic Radiology 1850426040 Practice locations: Los Angeles, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C28197CAMDRadiologic Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Avenue Imaging CurrentSince Apr 2, 2010 Accepting new patients
Prairie Medical Group Inc Past Accepting new patients
Prairie Medical Group Past Accepting new patients
La Vida Medical & Ipa Past Accepting new patients

Locations

1400 S Grand Ave
Ste 608
Los Angeles, CA 90015
Phone (213) 746-5800

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1295787984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4161 REDONDO BEACH BLVD",
            "address_2": "SUITE 201",
            "city": "LAWNDALE",
            "state": "CA",
            "postal_code": "902603306",
            "telephone_number": "310-214-8677",
            "fax_number": "310-921-1718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 SANTA MONICA BLVD",
            "address_2": "SUITE 301",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042429",
            "telephone_number": "310-829-3130",
            "fax_number": "310-828-9156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDAU",
        "first_name": "EARL",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247100000X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist",
            "state": "CA",
            "license": "C28197",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "C28197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.