Individual
UTHA ANDHIKA LUMBANTOBING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DNAP, CRNA
Contact information
Practice address
2051 MARENGO ST, LOS ANGELES, CA 90033-1352
(323) 409-7735
Mailing address
1764 N ENCINA AVE, RIALTO, CA 92376-2938
(909) 996-9222
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
95002375
CA
Other
Enumeration date
05/23/2024
Last updated
05/23/2024
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