TJAHJADI ANDY KUSUMO

ANAHEIM, CA
NPI1245366020
Former NameTJAHJADI KUSUMO-RAHARDJO
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: CA  49917)
Enumeration Date2007-02-26
Last Update Date2025-08-15
Business Address
Dr. TJAHJADI ANDY KUSUMO DDS
501 N BROOKHURST ST STE 100
ANAHEIM, CA 92801-5202
Phone number: 714-392-8283
Mailing Address
Dr. TJAHJADI ANDY KUSUMO DDS
222 S EMERALD ST
ANAHEIM, CA 92804-2525
Phone number: 949-769-0495
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