Provider Demographics
NPI:1033145602
Name:PFEFFINGER, LANDRUS L (MD)
Entity type:Individual
Prefix:
First Name:LANDRUS
Middle Name:L
Last Name:PFEFFINGER
Suffix:
Gender:M
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:PO BOX 1964
Mailing Address - Street 2:
Mailing Address - City:SONOMA
Mailing Address - State:CA
Mailing Address - Zip Code:95476-1964
Mailing Address - Country:US
Mailing Address - Phone:925-284-0433
Mailing Address - Fax:925-284-1505
Practice Address - Street 1:911 MORAGA RD
Practice Address - Street 2:STE 102
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-4579
Practice Address - Country:US
Practice Address - Phone:925-284-0433
Practice Address - Fax:925-284-1505
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2014-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG32258207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G322580Medicare ID - Type Unspecified
CAA45077Medicare UPIN
CA00G322581Medicare ID - Type Unspecified