Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Iwan Nyotowidjojo, MD

Individual provider Internal Medicine Physician · NPI 1578976270

Iwan Nyotowidjojo, MD is an Internal Medicine in Rancho Santa Margarita, California. Graduated from University of Vermont College of Medicine in 2014, 12 years ago. Practices with Friends of Family Health Center, an 11-clinician group and accepts Medicare assignment. Licensed in Alabama, Arizona, California and Colorado and 10 more.

Years since qualifying
12
Trained at
University of Vermont College of Medicine
Licensed in
AL, AZ, CA, CO, DE, FL
In the registry since
2014
Specialties on file
15
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

29472 Avenida De Las Banderas
Rancho Santa Margarita, CA 92688
Phone: (949) 459-9968
Fax: (949) 766-2565
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence A167115 (CA)
Internal Medicine Physician Taxonomy 207R00000X · Licence 45679 (AL)
Internal Medicine Physician Taxonomy 207R00000X · Licence 01089040A (IN)
Internal Medicine Physician Taxonomy 207R00000X · Licence TW-00242 (KS)
Internal Medicine Physician Taxonomy 207R00000X · Licence C1300 (KY)
Internal Medicine Physician Taxonomy 207R00000X · Licence 334744 (LA)
Internal Medicine Physician Taxonomy 207R00000X · Licence D0096206 (MD)
Internal Medicine Physician Taxonomy 207R00000X · Licence MD26749 (ME)
Internal Medicine Physician Taxonomy 207R00000X · Licence CL-0025782 (DE)
Internal Medicine Physician Taxonomy 207R00000X · Licence 68913 (AZ)
Internal Medicine Physician Taxonomy 207R00000X · Licence DR.0069772 (CO)
Internal Medicine Physician Taxonomy 207R00000X · Licence R74508 (AZ)
Internal Medicine Physician Taxonomy 207R00000X · Licence MD-50889 (IA)
Internal Medicine Physician Taxonomy 207R00000X · Licence MC-1884 (ID)
Internal Medicine Physician Taxonomy 207R00000X · Licence TPME4194 (FL)

Record details

NPI number1578976270
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 10, 2014
Last updated in NPPESJuly 17, 2024
Certification dateJuly 17, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolUNIVERSITY OF VERMONT COLLEGE OF MEDICINE
Graduated 2014 (12 years in practice)
Group practice Friends Of Family Health Center — 11 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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