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Search › California › 2085R0202X

Agustinus Suhardja, MD

NPI 1235349473 · on the registry since 2007

Practice

Address
828 S Grand Ave Ste 104
Glendora, CA 91740
Phone
(626) 963-2057
Fax
(626) 963-4298
Organisation at this address
Emanate Health Imaging
California Diagnostic Imaging Center A Medical Corporation
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy
2085R0202X
2085R0202X
Also registered as
2085R0202X
2085R0202X
2085R0202X
Licence states on file
KS, MD, VA, CA
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2021-11-29

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California