Individual
MR. IRWAN WIDJAJA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.AC
Contact information
Practice address
1481 W LONGHILL DR, MONTEREY PARK, CA 91754-4518
(626) 888-9119
Mailing address
1481 W LONGHILL DR, MONTEREY PARK, CA 91754-4518
(626) 888-9119
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
13474
CA
Other
Enumeration date
05/12/2010
Last updated
05/26/2013
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