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Search › California › 207R00000X

Iwan Nyotowidjojo, M.D

NPI 1578976270 · on the registry since 2014

Practice

Address
29472 Avenida De Las Banderas
Rancho Santa Margarita, CA 92688
Phone
(949) 459-9968
Fax
(949) 766-2565
Clinicians at this address
7

Registry record

Primary taxonomy
207R00000X
207R00000X
Also registered as
207R00000X
207R00000X
207R00000X
207R00000X
207R00000X
207R00000X
207R00000X
207R00000X
207R00000X
207R00000X
207R00000X
207R00000X
207R00000X
207R00000X
Licence states on file
AL, IN, KS, KY, LA, MD, ME, CA, DE, AZ, CO, IA, ID, FL
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2024-07-17

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