| Stefanus Muljana Md Inc | |
|
724 N Garey Ave Pomona CA 91767-4614 | |
| (909) 865-6255 | |
| (909) 865-6355 |
| Full Name | Stefanus Muljana Md Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 724 N Garey Ave, Pomona, California |
| Authorized Official Name and Position | Stefanus Muljana (PRESIDENT) |
| Authorized Official Contact | 9098656255 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stefanus Muljana Md Inc 724 N Garey Ave Pomona CA 91767-4614 Ph: (909) 865-6255 | Stefanus Muljana Md Inc 724 N Garey Ave Pomona CA 91767-4614 Ph: (909) 865-6255 |
| NPI Number | 1083972285 |
|---|---|
| Provider Enumeration Date | 04/25/2012 |
| Last Update Date | 04/25/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083972285 | NPI | - | NPPES |
| 00A395051 | Medicaid | CA | |
| A39505B | Other | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A39505 (California) | Primary |
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