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Individual
DR. BRIAN THEODORE SOETIKNO
Active
Individual
DR. BRIAN THEODORE SOETIKNO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
A181412
CA
207WX0107X
Retina Specialist (Ophthalmology) Physician
A181412
CA
Other
Enumeration date
02/16/2015
Last updated
07/01/2025
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