Individual
ALFONSUS P HARDOSUBROTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1397 SUN TREE DR, ROSEVILLE, CA 95661-5344
(916) 899-5604
Mailing address
1397 SUN TREE DR, ROSEVILLE, CA 95661-5344
(916) 899-5604
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
315002920
CA
Other
Enumeration date
12/18/2025
Last updated
12/18/2025
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