Individual
MR. SANJAYA SATRIYA UTAMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
190 SIERRA CT UNIT B # A -115, PALMDALE, CA 93550
(661) 886-0287
Mailing address
190 SIERRA CT # B # A - 115, PALMDALE, CA 93550-7607
(661) 886-0287
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
08/29/2014
Last updated
11/05/2018
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