Agustinus Suhardja, MD
Agustinus Suhardja, MD is a Diagnostic Radiology in Glendora, California. Qualified in 1995, 31 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment. Licensed in California, Kansas, Maryland and Virginia.
- Years since qualifying
- 31
- Licensed in
- CA, KS, MD, VA
- In the registry since
- 2007
- Specialties on file
- 4
What do these letters mean?
- MD — Doctor of Medicine
- A physician who completed allopathic medical school.
Practice location Address checks out
828 S Grand Ave Ste 104Glendora, CA 91740-4856
Phone: (626) 963-2057
Fax: (626) 963-4298
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Diagnostic Radiology Physician (primary) | Taxonomy 2085R0202X · Licence A89588 (CA) |
|---|---|
| Diagnostic Radiology Physician | Taxonomy 2085R0202X · Licence 04-34805 (KS) |
| Diagnostic Radiology Physician | Taxonomy 2085R0202X · Licence D0078407 (MD) |
| Diagnostic Radiology Physician | Taxonomy 2085R0202X · Licence 0101256807 (VA) |
Record details
| NPI number | 1235349473 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | MD |
| Sole proprietor | No |
| NPI enumerated | May 23, 2007 |
| Last updated in NPPES | November 29, 2021 |
| Mailing address | Po Box 6869, Orange, CA 92863-6869 |
Medicare enrollment
| Medicare specialty | DIAGNOSTIC RADIOLOGY |
|---|---|
| Medical school | OTHER |
| Graduated | 1995 (31 years in practice) |
| Group practice | Southern California Permanente Medical Group — 11242 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Practice locations | 4 on file with Medicare |
Other providers in Glendora
-
California Diagnostic Imaging Center a Medical Corporation
828 S Grand Ave Ste 104, Glendora, CA 91740-4856 · (626) 915-5181
-
Emanate Health Imaging
828 S Grand Ave Ste 104, Glendora, CA 91740 · (626) 963-2057
-
Menalam Health Services PC
250 S Grand Ave, Glendora, CA 91741-4218 · (626) 963-8411
-
William C. Chu, MD, Incorporated
150 W Route 66 Radiology Dept, Glendora, CA 91740-6207 · (626) 335-0231