IRAWAN SUSANTO

SANTA MONICA, CA
NPI1003836610
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207RC0200X Internal Medicine, Critical Care Medicine
(Licence: CA  c50280)
Additional Taxonomies207RP1001X Internal Medicine, Pulmonary Disease
(Licence: CA  C50280)
Enumeration Date2006-07-20
Last Update Date2014-02-06
Business Address
-- IRAWAN SUSANTO MD
1223 16TH ST SUITE 3400
SANTA MONICA, CA 90404-1217
Phone number: 310-449-0939
Mailing Address
-- IRAWAN SUSANTO MD
5767 W CENTURY BLVD SUITE 200
LOS ANGELES, CA 90045-5632
Phone number: 310-301-8708