Individual
DR. ANDREW SUMARTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
757 WESTWOOD PLZ, ROOM B713, LOS ANGELES, CA 90095-8358
(310) 825-8307
Mailing address
757 WESTWOOD PLZ, ROOM B713, LOS ANGELES, CA 90095-8358
(310) 825-8307
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A136147
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/04/2013
Last updated
07/14/2017
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