Healthcare Provider Details

I. General information

NPI: 1235251117
Provider Name (Legal Business Name): TYSON C. LANDEZA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2390 CRENSHAW BLVD STE E188
TORRANCE CA
90501-3300
US

IV. Provider business mailing address

2390 CRENSHAW BLVD STE E188
TORRANCE CA
90501-3300
US

V. Phone/Fax

Practice location:
  • Phone: 310-679-1890
  • Fax: 310-679-1898
Mailing address:
  • Phone: 310-679-1890
  • Fax: 310-679-1898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberA92168
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: