Provider Demographics
NPI:1851142558
Name:LANDEGGER, LUKAS DAVID (MD, PHD)
Entity type:Individual
Prefix:
First Name:LUKAS
Middle Name:DAVID
Last Name:LANDEGGER
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:LUKAS
Other - Middle Name:DAVID
Other - Last Name:LANDEGGER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:300 PASTEUR DR
Mailing Address - Street 2:
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305-2200
Mailing Address - Country:US
Mailing Address - Phone:650-723-4000
Mailing Address - Fax:
Practice Address - Street 1:300 PASTEUR DR
Practice Address - Street 2:
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-2200
Practice Address - Country:US
Practice Address - Phone:650-723-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-29
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CASPI818207Y00000X, 207YX0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & Neurotology