MEDICARE: HELEN LANDAYAN LO NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	13231	CA

General Provider Information

NPI Number	:	1013042498
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HELEN LANDAYAN LO NP

Provider Business Mailing Address
First Line	:	30007 CABO DEL OESTE
Second Line	:
City	:	HIGHLAND
State	:	CA
Zip	:	92346-5952
Country	:	US
Telephone Number	:	909-894-4006
Fax Number	:

Provider Business Practice Location Address
First Line	:	7140 INDIANA AVENUE
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92503
Country	:	US
Telephone Number	:	951-358-6037
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2007
Last Update Date	:	12/21/2021

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