| Iwan Nyotowidjojo, MD | |
|
29472 Avenida De Las Banderas, Rancho Santa Margarita, CA 92688 | |
| (949) 459-9968 | |
| (949) 766-2565 |
| Full Name | Iwan Nyotowidjojo |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine |
| Experience | 10 Years |
| Location | 29472 Avenida De Las Banderas, Rancho Santa Margarita, California |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578976270 | NPI | - | NPPES |
| Facility Name | Location | Facility Type |
|---|---|---|
| Memorialcare Saddleback Medical Center | Laguna hills, CA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Memorialcare Medical Foundation | 8729277314 | 384 |
| Glutality Provider Group Pa | 9032549837 | 20 |
| Glutality Provider Group Pa | 9032549837 | 20 |
| Glutality Provider Group Pa | 9032549837 | 20 |
| Glutality Provider Group Pa | 9032549837 | 20 |
| Glutality Provider Group Pa | 9032549837 | 20 |
| Glutality Provider Group Pa | 9032549837 | 20 |
| Entity Name | Riverside Medical Clinic Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1720183403 PECOS PAC ID: 2961492327 Enrollment ID: O20040517000880 |
| Entity Name | Senior Care Medical Associates Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1790909042 PECOS PAC ID: 5294790929 Enrollment ID: O20070810000384 |
| Entity Name | Memorialcare Medical Foundation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1205167350 PECOS PAC ID: 8729277314 Enrollment ID: O20110113000219 |
| Entity Name | Signify Health Medical Associates Of California Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1124685169 PECOS PAC ID: 8325370570 Enrollment ID: O20191022000320 |
| Mailing Address | Practice Location Address |
|---|---|
| Iwan Nyotowidjojo, MD 29472 Avenida De Las Banderas, Rancho Santa Margarita, CA 92688 Ph: (949) 459-9968 | Iwan Nyotowidjojo, MD 29472 Avenida De Las Banderas, Rancho Santa Margarita, CA 92688 Ph: (949) 459-9968 |
Dr. Yolanda P Gomez, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 22342 Avenida Empresa, Suite 195, Rancho Santa Margarita, CA 92688 Phone: 949-713-9705 Fax: 949-858-3826 | |
Dr. Afshin Hamidi, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 30511 Avenida De Las Flores # 1064, Rancho Santa Margarita, CA 92688 Phone: 858-933-5050 Fax: 941-833-7581 | |
Siamak Zamani, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 29873 Santa Margarita Pkwy, Ste 100, Rancho Santa Margarita, CA 92688 Phone: 949-589-9114 Fax: 949-421-0763 | |
Susanna Yu Tan, M.D. Internal Medicine Medicare: Medicare Enrolled Practice Location: 1 Legacy Way, Rancho Santa Margarita, CA 92688 Phone: 626-319-8791 | |
Dr. Gwendolyn S Gore, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 29472 Ave De Las Banderas, Rancho Santa Margarita, CA 92688 Phone: 949-459-9968 Fax: 949-766-2565 | |
Dr. Shaparak Kamarei, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 29873 Santa Margarita Pkwy 100, Rancho Santa Margarita, CA 92688 Phone: 949-709-0988 Fax: 949-709-8377 |