Provider Demographics
NPI:1225452683
Name:LANDAU, ALLYN (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLYN
Middle Name:
Last Name:LANDAU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 LOMBARD ST # 419EAST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94111-1143
Mailing Address - Country:US
Mailing Address - Phone:415-505-1066
Mailing Address - Fax:510-655-4628
Practice Address - Street 1:101 LOMBARD ST # 419EAST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94111-1143
Practice Address - Country:US
Practice Address - Phone:415-505-1066
Practice Address - Fax:510-655-4628
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-05
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG37756207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology