Active NPI
Kyle H Landauer, MD
- Sports Medicine (Orthopaedic Surgery) Physician
- Los Angeles, CA
National Provider Identifier
1609923895
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Orthopaedic Surgery) Physician
- License
- C081322
- Practice address
- 8610 S Sepulveda Blvd
#202
Los Angeles, CA 90045-4008 - Phone
- (310) 641-0333
- Fax
- (818) 285-5958
- NPI assigned
- Jan 3, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Orthopaedic Surgery) Physician | 207XX0005X | C081322 | CA | Primary |
Addresses
Primary practice location
8610 S Sepulveda Blvd
#202
Los Angeles, CA 90045-4008
Mailing address
8610 S Sepulveda Blvd
#202
Los Angeles, CA 90045-4008
Phone (310) 641-0333
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609923895 | Other | CA | NPI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C081322 | CA | MD | Sports Medicine (Orthopaedic Surgery) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Glendale Fidelity Medical Group Inc | Past | Accepting new patients | |
| Long Beach Prime Medical Group Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Orthopaedic Surgery Physician
- Glendale, CA
- NPI 1801915327
-
- Orthopaedic Surgery Physician
- Long Beach, CA
- NPI 1205955986
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1609923895",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8610 S SEPULVEDA BLVD",
"address_2": "#202",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900454008",
"telephone_number": "310-641-0333",
"fax_number": "818-285-5958"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8610 S SEPULVEDA BLVD",
"address_2": "#202",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900454008",
"telephone_number": "310-641-0333",
"fax_number": "818-285-5958"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANDAUER",
"first_name": "KYLE",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-03",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207XX0005X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Sports Medicine",
"state": "CA",
"license": "C081322",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1609923895",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.