Individual
TYSON C. LANDEZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13352 HAWTHORNE BLVD, STE. B, HAWTHORNE, CA 90250-5805
(310) 679-1890
(310) 679-1898
Mailing address
13352 HAWTHORNE BLVD, STE. B, HAWTHORNE, CA 90250-5805
(310) 679-1890
(310) 679-1898
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
A92168
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A921680
—
CA
01
—
A92168
MEDICAL LICENSE #
CA
Enumeration date
04/04/2007
Last updated
07/09/2014
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