Healthcare Provider Details

I. General information

NPI: 1427118868
Provider Name (Legal Business Name): CHRIS LANDON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 05/10/2022
Certification Date: 05/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 HILLMONT AVE, BLDG 340 SUITE 302
VENTURA CA
93003-3099
US

IV. Provider business mailing address

800 S VICTORIA AVE # L4640
VENTURA CA
93009-2918
US

V. Phone/Fax

Practice location:
  • Phone: 805-652-6255
  • Fax: 805-641-4494
Mailing address:
  • Phone: 180-567-7514
  • Fax: 805-641-4494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0201X
TaxonomyPediatric Allergy/Immunology Physician
License NumberG380560
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG380560
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: