MUDJIANTO CHANDRA MD

Dr MUDJIANTO CHANDRA MD is a male medical professional, specializing in General Surgery. He graduated in 1983.

Contact

18370 BURBANK BLVD
SUITE 607
TARZANA
CA
913562833

Tel:

MUDJIANTO CHANDRA MD Information

Npi 1225152515
Pac Id 6305826876
Professional Enrollment Id I20040723001029
Last Name CHANDRA
First Name MUDJIANTO
Middle Name
Suffix
Gender M
Credential MD
Medical School Name OTHER
Graduation Year 1983
Primary Specialty GENERAL SURGERY
Secondary Specialty 1
Secondary Specialty 2
Secondary Specialty 3
Secondary Specialty 4
All Secondary Specialties
Organization Legal Name
Group Practice Pac Id
Number Of Group Practice Members
Line 1 Street Address 18370 BURBANK BLVD
Line 2 Street Address SUITE 607
Marker Of Address Line 2 Suppression
City TARZANA
State CA
Zip Code 913562833
Phone Number
Hospital Affiliation Ccn 1 050761
Hospital Affiliation Lbn 1 PROVIDENCE TARZANA MEDICAL CENTER
Hospital Affiliation Ccn 2
Hospital Affiliation Lbn 2
Hospital Affiliation Ccn 3
Hospital Affiliation Lbn 3
Hospital Affiliation Ccn 4
Hospital Affiliation Lbn 4
Hospital Affiliation Ccn 5
Hospital Affiliation Lbn 5
Professional Accepts Medicare Assignment Y

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