DR. ROY MULJADI SOETIKNO (NPI# 1922119916) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922119916 |
| Entity Type | Individual |
| Full Name | DR. ROY MULJADI SOETIKNO |
| Credential | MD |
| Practice Address |
2490 Hospital Dr Ste 211 Mountain View CA 94040-4125 |
| Practice Telephone | 6504923384 |
| Practice Fax Number | 6509633535 |
| Mailing Telephone | 6504923384 |
| Mailing Fax Number | 6509633535 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-04-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
G76556 | CA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3801 Miranda Ave # Gi111, Palo Alto, CA 943041207 | 6508490542 |
| Street Address |
2490 HOSPITAL DR STE 211 |
| City | MOUNTAIN VIEW |
| State | CA |
| Zip Code | 94040-4125 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518127216 | George Tinawi | Internal Medicine | 2490 Hospital Dr Ste 211, Mountain View, CA 94040-4125 | 2008-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184246696 | Peninsula Wellness Centre | Chiropractor | 2425 Callifornia St Ste E, Mountain View, CA 94040 | 2020-05-07 |
| 1225669674 | Mitera Inc. | Psychiatry & Neurology | 1049 El Monte Ave Ste C #633, Mountain View, CA 94040 | 2020-02-03 |
| 1144862343 | Lavon Hester Bobo | Marriage & Family Therapist | 836 W. El Camino, Mountain View, CA 94040 | 2019-10-09 |
| 1871141945 | Cindy Crystal Wong | Nurse Practitioner | 2630 West El Camino Real, Mountain View, CA 94040 | 2019-08-30 |
| 1003471129 | Jennifer Langsdorf Royer | Marriage & Family Therapist | 1059 El Monte Avenue, Suite B, Mountain View, CA 94040 | 2019-05-03 |
| 1255899332 | Joanna Lynn Quan | Social Worker | Palo Alto Medical Foundation, 701 E. El Camino Real, Mountain View, CA 94040 | 2019-03-07 |
| 1750861522 | Kelby Katz | Counselor | 575 S Rengstorff Ave Apt 80, Mountain View, CA 94040 | 2018-08-20 |
| 1861982472 | David Young Lee | Counselor | 870 E El Camino Real, Mountain View, CA 94040 | 2018-05-18 |
| 1740709260 | May Man Lowe | Pharmacist | 1517 Lloyd Way, Mountain View, CA 94040 | 2017-09-15 |
| 1134647753 | Ryan David Emery | Physical Therapist | 525 South Dr #211, Mountain View, CA 94040 | 2017-09-04 |
| Find all providers in zip 94040 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467687467 | Peninsula Gastroenterology Medical Group Inc | Internal Medicine | 2500 Hospital Dr Bldg 8, Mountain View, CA 94040-4106 | 2009-05-19 |
| 1174594394 | Andrew B Lipton | Internal Medicine | 2204 Grant Rd, Suite 104, Mountain View, CA 94040-3855 | 2006-01-27 |
| 1053790691 | Samuel N Marcus Md Inc. | Internal Medicine | 2490 Hospital Dr, Suite 211, Mountain View, CA 94040-4122 | 2015-05-28 |
| 1437497096 | Advanced Gi Endoscopy Inc | Internal Medicine | 2490 Hospital Dr, 211, Mountain View, CA 94040-4122 | 2013-01-16 |
| 1588814313 | Andrew B Lipton Md A Professional Corporation | Internal Medicine | 2204 Grant Rd, Suite 104, Mountain View, CA 94040-3855 | 2008-09-29 |
| 1518127216 | George Tinawi | Internal Medicine | 2490 Hospital Dr Ste 211, Mountain View, CA 94040-4125 | 2008-06-16 |
| 1699972927 | Katerina P Shetler | Internal Medicine | 701 E El Camino Real, Mountain View, CA 94040-2833 | 2007-06-29 |
| 1851502694 | Robert Bronstone Inc. | Internal Medicine | 2500 Hospital Dr Bldg 15, Mountain View, CA 94040-4106 | 2007-05-24 |
| 1568519254 | Robert Bronstone | Internal Medicine | 2500 Hospital Dr, Mountain View, CA 94040-4106 | 2007-01-04 |
| 1063578714 | George Triadafilopoulos Md Inc | Internal Medicine | 2490 Hospital Dr, Ste. 211, Mountain View, CA 94040 | 2006-12-28 |
| Find all providers in MOUNTAIN VIEW | ||||
| City | MOUNTAIN VIEW |
| Zip Code | 94040 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.