Individual
DR. ROBERTUS HASAN KOUNANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
400 N PEPPER AVE, 212, COLTON, CA 92324-1801
(909) 580-6250
(909) 580-6369
Mailing address
646 PALO ALTO DR, REDLANDS, CA 92373-7321
(909) 793-4585
(909) 307-8031
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
A40627
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A406270
—
CA
Enumeration date
07/21/2005
Last updated
12/05/2022
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