Healthcare Provider Details

I. General information

NPI: 1033145602
Provider Name (Legal Business Name): LANDRUS L PFEFFINGER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 12/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 MORAGA RD STE 102
LAFAYETTE CA
94549-4579
US

IV. Provider business mailing address

PO BOX 1964
SONOMA CA
95476-1964
US

V. Phone/Fax

Practice location:
  • Phone: 925-284-0433
  • Fax: 925-284-1505
Mailing address:
  • Phone: 925-284-0433
  • Fax: 925-284-1505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberG32258
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: