Individual
BERNARDUS GANI SUGIARTO KARTONO WINARDI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
425 W CENTRAL AVE, SUITE 201, LOMPOC, CA 93436-2805
(805) 737-1169
(805) 737-1772
Mailing address
2050 S BLOSSER RD, SANTA MARIA, CA 93458-7310
(805) 361-8028
(805) 361-8097
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A135298
CA
282N00000X
General Acute Care Hospital
—
—
Other
Enumeration date
01/19/2013
Last updated
11/21/2016
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