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Individual
DR. JOSEPHUS-IAN LUMONGSUD SANJORJO
Active
Individual
DR. JOSEPHUS-IAN LUMONGSUD SANJORJO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A117377
CA
207RN0300X
Nephrology Physician
Primary
A117377
CA
208M00000X
Hospitalist Physician
A117377
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12257286
CAQH
—
01
—
H26222966
PTAN
—
Enumeration date
06/16/2011
Last updated
02/07/2015
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