Provider Demographics
NPI:1700115698
Name:LANDSBERGER, JOHN ADAM (DO)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ADAM
Last Name:LANDSBERGER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10970 BELLAGIO RD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90077-3203
Mailing Address - Country:US
Mailing Address - Phone:310-617-3302
Mailing Address - Fax:
Practice Address - Street 1:10970 BELLAGIO RD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90077-3203
Practice Address - Country:US
Practice Address - Phone:310-617-3302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-23
Last Update Date:2009-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A48722085R0001X, 208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology