Tjahjadi Kusumo-Rahardjo in Anaheim - General Practice
Tjahjadi Kusumo-Rahardjo - NPI 1245366020
Tjahjadi Kusumo-Rahardjo is a General Practice in Anaheim, California. Tjahjadi Kusumo-Rahardjo practices all healthcare services and medical treatments related to General Practice. The NPI Number for Tjahjadi Kusumo-Rahardjo is 1245366020. The last update date is 2013-05-07.
Tjahjadi Kusumo-Rahardjo's current location address is 222 S Emerald St, Anaheim, California. You can contact this provider via phone number 9497690495 and fax number 7144002085. The mailing address for Tjahjadi Kusumo-Rahardjo is 222 S Emerald St, Anaheim, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Tjahjadi Kusumo-Rahardjo |
|---|---|
| Address | 222 S Emerald St, Anaheim, California |
| Phone Number | 9497690495 |
| Fax Number | 7144002085 |
| Sole Proprietor | Y |
| Credentials | DDS |
NPI Number Detail
| NPI Number | 1245366020 |
|---|---|
| Provider Enumeration Date | 2007-02-26 |
| Last Updated Date | 2013-05-07 |
Provider Mailing Address Detail
| Address | 222 S Emerald St |
|---|---|
| City | Anaheim |
| State | California (CA) |
| Post Code | 928042525 |
| Phone Number | 9497690495 |
| Fax Number | 7144002085 |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 1223G0001X |
| Licence No | 49917 |
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Definition: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| D49917 | CA | DENTIST |
Post Comment/ Review Below
What is the unique provider identifier assigned to Tjahjadi Kusumo-Rahardjo?
The Tjahjadi Kusumo-Rahardjo has been issued the NPI (National Provider Identifier) 1245366020 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you share the physical location details of Tjahjadi Kusumo-Rahardjo?
The Tjahjadi Kusumo-Rahardjo is situated at 222 S Emerald St, in the city of Anaheim, state of CA, with the zip code 928042525.
What is the area of specialization for Tjahjadi Kusumo-Rahardjo, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Tjahjadi Kusumo-Rahardjo is General Practice, and the corresponding taxonomy code that categorizes this area of expertise is 1223G0001X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1245366020 to Tjahjadi Kusumo-Rahardjo?
The Centers for Medicare & Medicaid Services originally issued the 1245366020 to Tjahjadi Kusumo-Rahardjo on 2007-02-26.
As of what date were the Tjahjadi Kusumo-Rahardjo's details last updated?
The information pertaining to the Tjahjadi Kusumo-Rahardjo, including its address, specialty, and other details, was most recently updated on 2013-05-07.