Individual
DR. ANDREAS TJANDRA SUBADYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
623 W DUARTE RD, SUITE 4, ARCADIA, CA 91007-7330
(626) 446-4626
(626) 446-4656
Mailing address
623 W DUARTE RD, SUITE 4, ARCADIA, CA 91007-7330
(626) 446-4626
(626) 446-4656
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G063710
CA
Other
Enumeration date
10/16/2006
Last updated
11/05/2012
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