Provider Demographics
NPI:1427118868
Name:LANDON, CHRIS (MD)
Entity type:Individual
Prefix:
First Name:CHRIS
Middle Name:
Last Name:LANDON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 S VICTORIA AVE # L4640
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93009-2918
Mailing Address - Country:US
Mailing Address - Phone:180-567-7514
Mailing Address - Fax:805-641-4494
Practice Address - Street 1:300 HILLMONT AVE, BLDG 340 SUITE 302
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-3099
Practice Address - Country:US
Practice Address - Phone:805-652-6255
Practice Address - Fax:805-641-4494
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG3805602080P0201X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G380560Medicaid
CAA89652Medicare UPIN