Agustinus S Suhardja (NPI# 1235349473, PAC ID# 0941398481) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DIAGNOSTIC RADIOLOGY.
| Nation Provider ID (NPI) | 1235349473 |
| PAC ID by PECOS | 0941398481 |
| Professional Enrollment ID | I20071115000667 |
| Full Name | Agustinus S Suhardja |
| Organization Legal Name | GLENDORA RADIOLOGICAL ASSOC INC |
| Address |
210 W San Bernardino Rd Covina CA 91723-1515 |
| Phone Number | 6263317331 |
| Gender | M |
| Graduation Year | 1995 |
| Primary Specialty | DIAGNOSTIC RADIOLOGY |
| Group Practice PAC ID | 2163514589 |
| Number of Group Practice Members | 38 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050382 | CITRUS VALLEY MEDICAL CENTER-IC CAMPUS |
| 050723 | KAISER FOUNDATION HOSPITAL - BALDWIN PARK |
| 050597 | FOOTHILL PRESBYTERIAN HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1011 Baldwin Park Blvd, Baldwin Park, CA 91706-5806 | SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP | |
| 14371 Clark, Suite 1437, Bellflower, CA 90706-2901 | 5624613000 | SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP |
| 210 W San Bernardino Rd, Covina, CA 91723-1515 | 6263317331 | GLENDORA RADIOLOGICAL ASSOC INC |
| 9333 Imperial Hwy, Downey, CA 90242-2812 | 8009234040 | SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP |
| 9353 Imperial Hwy, Downey, CA 90242-2812 | 5626579000 | SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP |
| 9449 Imperial Hwy, Downey, CA 90242-2814 | 5624613000 | SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP |
| 250 S Grand Ave, Glendora, CA 91741-4218 | 6268573118 | GLENDORA RADIOLOGICAL ASSOC INC |
| 828 S Grand Ave, Suite 104, Glendora, CA 91740-4856 | 6269632057 | CITRUS DIAGNOSTIC IMAGING CORP |
| 12761 Schabarum Ave, Irwindale, CA 91706-6807 | 8776080044 | SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP |
| 1255 W Arrow Hwy, San Dimas, CA 91773-2340 | 9093942526 | SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP |
| 1249 S Sunset Ave, West Covina, CA 91790-3960 | 8007801277 | SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP |
| Organization Legal Name | GLENDORA RADIOLOGICAL ASSOC INC |
| Physicians | 27 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Douglas James Alden | Diagnostic Radiology | Glendora Radiological Assoc Inc | 373 Big Horn Ridge Dr Ne, Albuquerque, NM 87122-1424 |
| Duane Charles Wilson | Diagnostic Radiology | Glendora Radiological Assoc Inc | 57638 Red Alder Lane, Sunriver, OR 97707 |
| Michael J Grant | Diagnostic Radiology | Glendora Radiological Assoc Inc | 7703 N Warren Ln, Spokane, WA 99208-4978 |
| Eugene T Kim | Diagnostic Radiology | Glendora Radiological Assoc Inc | 20391 W Springfield St, Buckeye, AZ 85396-3544 |
| Jennifer Kim | Diagnostic Radiology | Glendora Radiological Assoc Inc | 35 Deacons Way, New Canaan, CT 06840-4221 |
| Catherine C Roberts | Diagnostic Radiology | Glendora Radiological Assoc Inc | 16236 N 110th St, Scottsdale, AZ 85255-2433 |
| Wendy E Zimmer | Diagnostic Radiology | Glendora Radiological Assoc Inc | 32 Saint Catherines Ct, Buffalo, NY 14222-1614 |
| Bruce J Thaler | Diagnostic Radiology | Glendora Radiological Assoc Inc | 110 S Front St, Philadelphia, PA 19106-3000 |
| Scott C Chang | Diagnostic Radiology | Glendora Radiological Assoc Inc | 8755 Killians Greens Dr, Las Vegas, NV 89131-6706 |
| Albert C Ybasco | Diagnostic Radiology | Glendora Radiological Assoc Inc | 46 Carillon Cir, Livingston, NJ 07039-2600 |
| Street Address |
210 W SAN BERNARDINO RD |
| City | COVINA |
| State | CA |
| Zip | 91723-1515 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| William F Pfisterer | Interventional Radiology | Glendora Radiological Assoc Inc | 210 W San Bernardino Rd, Covina, CA 91723-1515 |
| David J Underwood | Diagnostic Radiology | Glendora Radiological Assoc Inc | 210 W San Bernardino Rd, Covina, CA 91723-1515 |
| Timothy Bell | Diagnostic Radiology | Glendora Radiological Assoc Inc | 210 W San Bernardino Rd, Covina, CA 91723-1515 |
| Uri M Zisblatt | Radiation Oncology | 210 W San Bernardino Rd, Covina, CA 91723-1515 | |
| Steven A Floum | Internal Medicine | 210 W San Bernardino Rd, Citrus Valley Medical Center Interc, Covina, CA 91723-1515 | |
| Sergio A Hernandez | Emergency Medicine | Cep America - California | 210 W San Bernardino Rd, Covina, CA 91723-1515 |
| Nabil A Yassa | Diagnostic Radiology | Glendora Radiological Assoc Inc | 210 W San Bernardino Rd, Covina, CA 91723-1515 |
| James Y Hyun | Diagnostic Radiology | Glendora Radiological Assoc Inc | 210 W San Bernardino Rd, Covina, CA 91723-1515 |
| Rizwana Begum Hussain | Internal Medicine | 210 W San Bernardino Rd, Covina, CA 91723-1515 | |
| Ilyas M Khan | Diagnostic Radiology | Glendora Radiological Assoc Inc | 210 W San Bernardino Rd, Covina, CA 91723-1515 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Madhu Sudan | Internal Medicine | 530 W Badillo St A, Covina, CA 91723 | |
| Paul S Usborne | Family Medicine | 256 W San Bernardino Rd, Covina, CA 91723-1515 | |
| Kenneth A Frankel | Pathology | Citrus Pathology Medical Group | 210 W San Bernardino Rd, Covina, CA 91723-1515 |
| Xinke Chen | Internal Medicine | 210 W San Bernardino Rd, Covina, CA 91723-1515 | |
| Jimmy Ton | Diagnostic Radiology | Glendora Radiological Assoc Inc | 210 W San Bernardino Rd, Covina, CA 91723-1515 |
| Hamid R Mohazab | Diagnostic Radiology | Glendora Radiological Assoc Inc | 210 W San Bernardino Rd, Covina, CA 91723-1515 |
| Bach T Vu | Diagnostic Radiology | Glendora Radiological Assoc Inc | 210 W San Bernardino Rd, Covina, CA 91723-1515 |
| Donald M Alpiner | Family Medicine | 210 W San Bernardino Rd, Covina, CA 91723-1515 | |
| David Su-sien Lin | Diagnostic Radiology | Glendora Radiological Assoc Inc | 210 W San Bernardino Rd, Covina, CA 91723-1515 |
| Arsalan Geula | Internal Medicine | 210 W San Bernardino Rd, Covina, CA 91723-1515 | |
| Find all physicians in zip 91723 | |||
| City | COVINA |
| Zip Code | 91723 |
| Specialty | DIAGNOSTIC RADIOLOGY |
| City + Specialty | COVINA + DIAGNOSTIC RADIOLOGY |
Please comment or provide details below to improve the information on Agustinus S Suhardja.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.